LDCT、肿瘤相关自身抗体、TFPI-2基因甲基化联合检测对肺癌的早期诊断价值  

Value of Combined Examination of LDCT,Tumour-Associated Autoantibodies and TFPI-2 Methylation in the Early Screening for Lung Cancer

作　　者：石俊英 王慧 张斯佳 李铭[2] SHI Junying;WANG Hui;ZHANG Sijia(Fifth Clinical Medical School of Henan University of Chinese Medicine,People's Hospital of Zhengzhou,Zhengzhou,450003)

机构地区：[1]河南中医药大学第五临床医学院,郑州人民医院,450003 [2]复旦大学附属华东医院,200040

出　　处：《实用癌症杂志》2023年第10期1634-1637,1653,共5页The Practical Journal of Cancer

基　　金：河南省医学科技攻关计划联合共建项目和软科学项目(编号:LHGJ20210698)。

摘　　要：目的研究低剂量CT(LDCT)、肿瘤相关自身抗体、组织因子途径抑制物-2(TFPI-2)基因甲基化联合检测对肺癌的早期诊断价值。方法选取109例疑似早期肺癌患者作为研究对象,所有患者均接受LDCT检查,以术后病理学检查作为金标准,分析LDCT检出率以及阳性患者和阴性患者肿瘤相关自身抗体、TFPI-2基因甲基化阳性率,分析LDCT联合肿瘤相关自身抗体[P5、RNA解螺旋酶自身抗体4-5(GBU4-5)、黑色素瘤抗原A1(MAGE A1)、肿瘤相关基因(CAGE)、性别决定基因家族2(SOX2)、蛋白基因产物9.5(PGP9.5)、G抗原7(GAGE7)]和TFPI-2基因甲基化对于早期肺癌的诊断价值。结果109例疑似肺患者经过病理学检查确诊101例,LDCT诊断肺癌阳性85例,检出率为84.15%;与阴性组患者相比,阴性组患者肿瘤相关自身抗体SOX2、PGP9.5和GAGE7水平显著更高(P<0.05);与阴性组患者TFPI-2基因甲基化阳性率[12.50%(1/8)]相比,阳性组患者[48.51%(49/101)]显著更高(P<0.05);经过ROC曲线分析结果发现,LDCT+P53+MAGEA1+GAGE+SOX2+PGP9.5+GAGE7+GBU4-5联合TFPI-2基因甲基化对于早期肺癌的诊断灵敏度和特异度均高于任意单一指标(P<0.05)。结论综上所述,LDCT、7种肿瘤相关自身抗原联合TFPI-2基因甲基化检测,可提高对于早期肺癌的诊断价值。Objective To investigate value of combined examination of low-dose computed tomographic(LDCT),tumour-associated autoantibodies and tissue factor pathway inhibitor-2(TFPI-2)methylation in the early screening for lung cancer.Methods 109 patients suspected for early stage lung cancer were enrolled.All patients received LDCT examination.Taking postoperative pathology as the gold standard,the LDCT detection rate and the positive rate of tumour-associated autoantibodies and TFPI-2 gene methylation in positive and negative patients were analyzed.Then the value of combined examination of LDCT,tumour-associated autoantibodies[P53,RNA helicase autoantibodies 4-5(GBU4-5),melanoma antigen A1(MAGE A1),cancer associated gene(CAGE),sex determining region Y-box 2(SOX2),protein gene product 9.5(PGP9.5),G antigen 7(GAGE7)]and TFPI-2 methylation in the early screening for lung cancer.Results Of the 109 suspected lung patients,101 were confirmed by pathological examination,and 85 were diagnosed positive by LDCT,with a detection rate of 84.15%.The levels of tumor-associated autoantibodies SOX2,PGP9.5 and GAGE7 were notably elevated in positive group compared with negative group(P<0.05).The rate of TFPI-2 methylation was 48.51%(49/101)in positive group,which was higher than 12.50%(1/8)in negative group,with statistical difference(P<0.05).ROC curve analysis showed that LDCT+P53+MAGEA1+GAGE+SOX2+PGP9.5+GAGE7+GBU4-5 combined with TFPI-2 methylation achieved higher diagnostic sensitivity and specificity for early diagnosis of lung cancer than the separate test(P<0.05).Conclusion The combined examination of LDCT,seven tumor-associated autoantigens and TFPI-2 gene methylation is of great diagnostic value for early lung cancer.

关 键 词：LDCT 肿瘤相关自身抗体 TFPI-2基因 肺癌 

分 类 号：R734.2[医药卫生—肿瘤]