联合SHOX2、RASSF1A及CEA构建的列线图模型对肺癌发生的预测价值  

Predictive value of nomogram model combined with short stature homeobox gene 2 (SHOX2),RAS association domain family 1,isoform A (RASSF1A) and carcinoembryonic antigen (CEA) in occurrence of lung cancer

作　　者：王萌萌 穆坎代斯·吐尔迪 努尔孜巴·艾力 考吾沙尔·巴合提江 夏宇[1] WANG Mengmeng;Mukandaisi Tuerdi;Nuerziba Aili;Kaowushaer Bahetijiang;XIA Yu(Department of Respiratory,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院呼吸与呼吸危重症中心二病区,乌鲁木齐830054

出　　处：《新疆医科大学学报》2024年第7期996-1000,1007,共6页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区科技援疆计划(2020E0272)。

摘　　要：目的 联合矮小同源盒基因2(Short stature homeobox gene 2,SHOX2)、RAS相关结构域家族1亚型A(RAS association domain family 1,isoform A,RASSF1A)及癌胚抗原(Carcinoembryonic antigen,CEA)构建预测肺癌发生的列线图模型,并确定该模型的预测价值。方法 选择2020年1月至2022年12月在新疆医科大学第一附属医院就诊的88例肺癌患者及肺良性肿瘤患者219名。比较两组患者的人口统计学和临床特征信息以及支气管肺泡灌洗液(Bronchoalveolar lavage fluid,BALF)中SHOX2和RASSF1A基因的甲基化水平。进行单因素分析及多因素Logistic回归分析筛选出影响肺癌发生的变量构建列线图,并评估其预测效能。结果 肺癌患者中SHOX2阳性36例(41.4%),RASSF1A阳性30例(34.5%)。肺癌患者CEA、细胞角蛋白19片段(Cytokeratin 19 fragment,CYFRA21-1)、鳞状上皮细胞癌抗原(Squamous cell carcinoma antigen,SCCA)、胃泌素释放肽前体(Pro-gastrinreleasing peptide,Pro-GRP)水平与肺良性肿瘤患者比较差异有统计学意义(P<0.05)。Logistic回归分析显示,SHOX2、RASSF1A和CEA为肺癌发生的独立危险因素(P<0.05),基于上述独立风险因素所构建的列线图模型显示出良好的区分能力(AUC=0.926),具有较好的一致性且获益良好。结论 联合SHOX2、RASSF1A和CEA构建的列线图模型对肺癌发生具有较高的预测价值,可为肺癌的早期诊断提供依据。Objectives Short stature homeobox gene 2(SHOX2),RAS association domain family 1,isoform A(RASSF1A) and carcinoembryonic antigen(CEA) wasused to construct a clinical model for predicting the occurrence of lung cancer,and its predictive value was determined.Methods A total of 88 patients with lung cancer and 219 patients with benign lung disease who were treated in the hospital from January 2020 to December 2022 were included.The demographics and clinical features of the 2 groups were compared,as well as the methylation levels of SHOX2 and RASSF1A genes in the bronchoalveolar lavage lavage fluid(Balf).Univariate analysis and multivariate Logistic regression analysis were used to screen out the variables affecting the occurrence of lung cancer and to construct nomogram.Results There were 36 patients(41.4%) positive for SHOX2 and 30 patients(34.5%) positive for RASSF1A in lung cancer group.CEA,cytokeratin 19 fragment(CYFRA21-1),squamous cell carcinoma antigen(SCCA)and pro-gastrin releasing peptide(Pro-GRP) were significantly different between the lung cancer group and control group(P<0.05).Logistic regression analysis showed that SHOX2,RASSF1A and CEA were independent risk factors for pulmonary malignancy(P<0.05),and a nomogram model was constructed based on the above independent risk factors.The prediction model showed good differentiation ability(AUC=0.926,P=0.154),good consistency and benefit.Conclusion The nomogram model combined with SHOX2,RASSF1A and CEA has high predictive value and can provide basis for early diagnosis of lung cancer.

关 键 词：矮小同源盒基因2 RAS相关结构域家族1亚型A 癌胚抗原 肺癌 列线图 

分 类 号：R734.2[医药卫生—肿瘤]