血清uMtCK检测在非小细胞肺癌诊断中的应用价值  

Value of serum uMtCK detection in diagnosis of non-small cell lung cancer

作　　者：李志文 辛倩 李晨瑜 张磊[2] 毕庆庆 牟晓峰[2] LI Zhiwen;XIN Qian;LI Chenyu;ZHANG Lei;BI Qingqing;MU Xiaofeng(School of Medical Laboratory,Weifang Medical University,Shandong Weifang 261053,China;Department of Clinical Laboratory,Affiliated Qingdao Central Hospital of Qingdao University,Qingdao Cancer Hospital,Shandong Qingdao 266042,China)

机构地区：[1]潍坊医学院医学检验学院,山东潍坊261053 [2]青岛大学附属青岛市中心医院,青岛市肿瘤医院检验科,山东青岛266042

出　　处：《现代肿瘤医学》2024年第20期3875-3879,共5页Journal of Modern Oncology

基　　金：山东省青岛市市级临床重点专科(编号:青卫政字〔2022〕6号)。

摘　　要：目的:探究血清中广泛型线粒体肌酸激酶(uMtCK)水平在非小细胞肺癌(NSCLC)临床诊断和预后监测中的应用价值,评估血清uMtCK、细胞角蛋白19片段(CYFRA21-1)与癌胚抗原(CEA)联合检测在NSCLC中的辅助诊断效能。方法:纳入2023年03月至2023年08月NSCLC患者作为本研究实验组,同期健康体检人群作为对照组,应用化学发光法检测两组人群血清样本中uMtCK、CYFRA21-1、CEA水平,评估检测水平差异。采用ROC曲线分析单一或联合检测uMtCK、CYFRA21-1、CEA在NSCLC患者中的诊断准确性。结果:本研究共纳入149例NSCLC新发患者为新发患者组、130例经过治疗的NSCLC患者为经治疗患者组,两组为实验组,85名健康体检者为对照者,总体、男性、女性NSCLC患者血清中uMtCK水平明显高于相应对照人群(42.30 vs 10.10,34.40 vs 8.40,62.90 vs 14.3,P<0.05);ROC曲线分析显示,uMtCK检测对总人群、男性、女性NSCLC患者的AUC分别为0.818、0.834、0.828;uMtCK、CYFRA21-1、CEA三项联合检测对总体、男性、女性NSCLC患者的AUC分别为0.913、0.931、0.909,高于三项标志物单独检测的AUC;对数转换后的多因素Logistic回归分析显示uMtCK的OR值为3.09,明显高于CYFRA21-1与CEA(1.82、1.67),对数转换后的多因素Logistic回归模型的AUC是0.954。疾病分期研究表明Ⅰ-Ⅱ期患者血清中uMtCK表达水平高于Ⅲ-Ⅳ期者(P<0.05)。手术治疗后Ⅰ-Ⅱ期患者uMtCK水平低于未经治疗Ⅰ-Ⅱ期患者,差异具有统计学意义(P<0.05)。结论:血清uMtCK水平可用于NSCLC尤其是早期患者的辅助诊断,并可用于监测早期NSCLC患者术后疗效。uMtCK、CYFRA21-1、CEA三项联合及对数转换后的多因素Logistic回归模型可有效提高NSCLC诊断效能。Objective:To investigate the value of serum ubiquitous mitochondrial creatine kinase(uMtCK)level for clinical diagnosis and prognostic monitoring of non-small cell lung cancer(NSCLC),and the value of the combination of serum uMtCK,cytokeratin fragment 19(CYFRA21-1)and carcino-embryonic antigen(CEA)for diagnosis of NSCLC.Methods:NSCLC patients from March 2023 to August 2023 were included as the experimental group of this study,and the healthy check-up population during the same period was used as the control group,and the levels of serum uMtCK,CYFRA21-1,and CEA of two groups were detected by chemiluminescence immunoassay(CLIA)to evaluate the differences.The diagnostic accuracy of single or combined detection of uMtCK,CYFRA21-1,CEA in NSCLC patients was analyzed by ROC curve.Results:A total of 149 newly discovered NSCLC patients,130 treated NSCLC patients and 85 healthy controls were included in this study.Serum uMtCK levels of overall,male,and female NSCLC patients were significantly higher than those of the corresponding control populations(42.30 vs 10.10,34.40 vs 8.40,62.90 vs 14.3,P<0.05).ROC curve analysis showed that the AUC of the uMtCK assay for the total population,male and female patients was 0.818,0.834 and 0.828,respectively.The AUC of the combined uMtCK,CYFRA21-1,and CEA assays for the total population,male and female patients was 0.913,0.931 and 0.909,respectively,which was higher than the AUC of the three markers alone.The log-transformed multifactorial Logistic regression analysis showed that the OR of uMtCK was 3.09,significantly higher than that of CYFRA21-1 and CEA,and the AUC of the log-transformed multifactorial Logistic regression model was 0.954.Disease staging study showed that the serum expression level of uMtCK in patients with stageⅠ-Ⅱwas higher than that of patients with stageⅢ-Ⅳ(P<0.05).The level of uMtCK was lower in surgically treated stage I-II patients than in untreated stage I-II patients,and the difference was statistically significant(P<0.05).Conclusion:Serum uMtCK level

关 键 词：广泛型线粒体肌酸激酶 细胞角蛋白19片段 癌胚抗原 联合检测 非小细胞肺癌 

分 类 号：R734.2[医药卫生—肿瘤]