血清和胸腔积液HE4、CD147、SCC-Ag、CEA在诊断非小细胞肺癌合并恶性胸腔积液中的价值  

Potential of a combination measurement of serum and pleural fluid levels of HE4,CD147,SCC-Ag and CEA in non-small cell lung cancer combined with malignant pleural effusion

作　　者：许琼 熊英友 张微 吴倩 文静 吴雪虎 Xu Qiong;Xiong Yingyou;Zhang Wei;Wu Qian;Wen Jing;Wu Xuehu(Department of Oncology,Minda Hospital of Hubei Minzu University,Enshi 445000,China)

机构地区：[1]湖北民族大学附属民大医院肿瘤科,恩施445000

出　　处：《国际呼吸杂志》2024年第3期305-310,共6页International Journal of Respiration

摘　　要：目的探讨血清和胸腔积液中人附睾蛋白4(HE4)、细胞外基质金属蛋白酶诱导因子(CD147)、鳞状上皮细胞癌抗原(SCC-Ag)、癌胚抗原(CEA)对应的指标联合,在诊断非小细胞肺癌(NSCLC)合并恶性胸腔积液方面的价值。方法本研究为病例对照研究。采用非随机抽样的方法纳入2019年6月至2022年6月湖北民族大学附属民大医院的150例NSCLC合并恶性胸腔积液患者(恶性组)和50例良性胸腔积液患者(良性组)。比较2组血清和胸腔积液中HE4、CD147、SCC-Ag、CEA水平。采用受试者工作特征(ROC)曲线分析血清和胸腔积液中HE4、CD147、SCC-Ag、CEA对NSCLC患者合并恶性胸腔积液的诊断价值。采用Kappa检验比较病理诊断与血清和胸腔积液中HE4、CD147、SCC-Ag、CEA联合诊断NSCLC合并恶性胸腔积液的一致性,以任一指标阳性为联合诊断阳性。结果恶性组男80例,女70例,年龄(69.24±8.67)岁,吸烟70例。良性组男34例,女16例,年龄(68.54±8.34)岁,吸烟18例。2组患者性别、年龄、吸烟情况比较差异均无统计学意义(均P>0.05)。恶性组血清和胸腔积液中HE4、CD147、SCC-Ag、CEA水平均较良性组高(均P<0.001)。ROC曲线分析显示,血清HE4、CD147、SCC-Ag、CEA诊断NSCLC合并恶性胸腔积液的曲线下面积分别为0.821、0.856、0.923、0.943,胸腔积液中HE4、CD147、SCC-Ag、CEA诊断NSCLC合并恶性胸腔积液的曲线下面积分别为0.926、0.861、0.916、0.924。各指标诊断NSCLC合并恶性胸腔积液的最佳截断值分别为血清HE4141.89 pmol/L(敏感度0.687,特异度0.840)、血清CD14711.31μg/L(敏感度0.673,特异度0.920)、血清SCC-Ag 4.85μg/L(敏感度0.800,特异度0.920)、血清CEA 13.72μg/L(敏感度0.807,特异度0.940);胸腔积液HE41596.64 pmol/L(敏感度0.820,特异度0.860)、胸腔积液CD14716.13μg/L(敏感度0.807,特异度0.780)、胸腔积液SCC-Ag 21.76μg/L(敏感度0.840,特异度0.900)、胸腔积液CEA 26.15μg/L(敏感度0.847,特异度0.900)(均P<ObjectiveTo explore the diagnostic potential of a combination measurement of serum and pleural fluid levels of human epididymis protein 4(HE4),extracellular matrix metalloproteinase inducer(CD147),squamous cell carcinoma antigen(SCC-Ag),and carcinoembryonic antigen(CEA)in non-small cell lung cancer(NSCLC)combined with malignant pleural effusion.MethodsThis was a case-control study.A total of 150 NSCLC patients combined with malignant pleural effusion(malignant group)and 50 patients with benign pleural effusion(benign group)who were admitted in Minda Hospital of Hubei Minzu University from June 2019 to June 2022 were enrolled using the non-random sampling.HE4,CD147,SCC-Ag and CEA levels in serum and pleural fluid were compared between the two groups.The diagnostic value of serum and pleural fluid levels of HE4,CD147,SCC-Ag and CEA in NSCLC combined with malignant pleural effusion was tested by the receiver operator characteristic(ROC)curves.Kappa test was used to compare the consistency between the combination measurement of serum and pleural fluid levels of HE4,CD147,SCC-Ag and CEA with the pathological diagnosis of NSCLC with malignant pleural effusion,and the positivity of any indicator was regarded as a positive combined diagnosis.ResultsThere were 80 males and 70 females in the malignant group,with the mean age of 69.24±8.67 years.There were 34 males and 16 females in the benign group,with the mean age of 68.54±8.34 years.There were no significant differences in gender,age,and smoking status between the two groups(all P>0.05).HE4,CD147,SCC-Ag,and CEA levels in the serum and pleural fluid of the malignant group were significantly higher than those of the benign group(all P<0.001).ROC analysis showed that the areas under curve(AUC)of serum HE4,CD147,SCC-Ag,CEA in diagnosing NSCLC with malignant pleural effusion were 0.821,0.856,0.923,0.943,respectively,and AUC of pleural fluid HE4,CD147,SCC-Ag,CEA were 0.926,0.861,0.916,0.924,respectively.The optimal cutoff values for diagnosing NSCLC with malignant pleural e

关 键 词：癌 非小细胞肺 胸腔积液 恶性 癌胚抗原 人附睾蛋白4 细胞外基质金属蛋白酶诱导因子 鳞状上皮细胞癌抗原 

分 类 号：R734.2[医药卫生—肿瘤]