MMP-9、MMP-2及TLR4、HE4对非小细胞肺癌早期诊断意义  

Significance of MMP-9,MMP-2,TLR4,HE4 in early diagnosis of non-small cell lung cancer

作　　者：梁丽斯 李洁 贺帅 来艳君 刘铭 张琳 Liang Lisi;Li Jie;He Shuai;Lai Yanjun;Liu Ming;Zhang Lin(Department of Clinical Laboratory,Xi′an Ninth Hospital Xi′an 710054,China;Department of Respiratory and Critical Care Medicine,Xi′an Ninth Hospital Xi'an 710054,China)

机构地区：[1]西安市第九医院检验科,西安710054 [2]西安市第九医院呼吸与危重症医学科,西安710054

出　　处：《中华肺部疾病杂志（电子版）》2024年第5期756-761,共6页Chinese Journal of Lung Diseases(Electronic Edition)

基　　金：陕西省自然科学基础研究计划资助项目(2019JQ⁃829)。

摘　　要：目的分析血清基质金属蛋白酶9(matrix metalloproteinases-9,MMP-9)、基质金属蛋白酶2(matrix metalloproteinase 2,MMP-2)及Toll样受体4(toll-like receptor 4,TLR4)、人附睾蛋白4(human epididymis protein 4,HE4)用于非小细胞肺癌(non-small cell lung carcinoma,NSCLC)早期诊断的意义。方法收集2021年1月至2023年12月我院收治的35例NSCLC患者为观察组,选取同期住院肺部良性病变患者39例为对照组。比较两组血清MMP-9、MMP-2、TLR4、HE4水平,比较不同临床病理特征NSCLC患者的血清MMP-9、MMP-2、TLR4、HE4水平。通过受试者工作特征曲线(ROC)分析血清MMP-9、MMP-2、TLR4、HE4单项对NSCLC诊断,采取多因素Logistic回归性分析血清MMP-9、MMP-2及TLR4、HE4与NSCLC的相关性。结果观察组MMP-9、MMP-2、TLR4、HE4水平[(288.71±92.33)μg/L、(44.46±5.62)pg/ml、(5.30±1.24)ng/ml、(228.76±60.83)pmol/L]高于对照组[(214.66±45.89)μg/L、(20.15±4.03)pg/ml、(2.58±0.84)ng/ml、(57.76±18.14)pmol/L](P<0.05)。TNM分期Ⅲ~Ⅳ期、低分化、淋巴结转移的NSCLC患者血清MMP-9、MMP-2、TLR4、HE4水平高于TNM分期Ⅰ~Ⅱ期、中高分化、无淋巴结转移的NSCLC患者(P<0.05)。经ROC分析,血清MMP-9、MMP-2、TLR4、HE4单项诊断NSCLC的曲线下面积为0.790(95%CI:0.690~0.890)、0.804(95%CI:0.703~0.904)、0.813(95%CI:0.715~0.912)、0.817(95%CI:0.720~0.914),敏感性为0.650(95%CI:0.596~0.712)、0.800(95%CI:0.724~0.870)、0.750(95%CI:0.689~0.834)、0.775(95%CI:0.703~0.852),特异性为0.825(95%CI:0.763~0.884)、0.750(95%CI:0.688~0.825)、0.825(95%CI:0.778~0.871)、0.800(95%CI:0.734~0.846);血清MMP-9、MMP-2、TLR4、HE4联合诊断NSCLC的曲线下面积为0.953(95%CI:0.912~0.993),敏感性为0.850(95%CI:0.782~0.913),特异性为0.925(95%CI:0.862~0.979)。多因素Logistic回归分析显示,MMP-9≥237.465μg/L(OR=2.587,95%CI:1.241~5.393)、MMP-2≥29.115 pg/ml(OR=3.129,95%CI:1.336~7.328)、TLR4≥3.870 ng/ml(OR=3.202,95%CI:1.411~7.266)、HE4≥128.030 pmol/L(OR=3.415,95%CI:1.508~7.734)Objective To analyze the significance of serum matrix metalloproteinases 9(MMP-9),matrix metalloproteinase 2(MMP-2)and toll-like receptor 4(TLR4),human epididymis protein 4(HE4)in early diagnosis of non-small cell lung carcinoma(NSCLC).Methods 35 patients with NSCLC admitted to our hospital from January 2021 to December 2023 were selected as the observation group,and 39 patients with benign lung lesions hospitalized during the same period were selected as the control group.The serum levels of MMP-9,MMP-2,TLR4 and HE4 were compared between the two groups,and the serum levels of MMP-9,MMP-2,TLR4 and HE4 in NSCLC patients with different clinicpathological characteristics were compared.The correlation between serum MMP-9,MMP-2,TLR4 and HE4 for the diagnosis of NSCLC was analyzed by receiver operating characteristic curve(ROC).The correlation between serum MMP-9,MMP-2,TLR4 and HE4 and NSCLC was analyzed by multivariate Logistic regression.Results The levels of MMP-9,MMP-2,TLR4 and HE4 in the observation group[(288.71±92.33)μg/L,(44.46±5.62)pg/ml,(5.30±1.24)ng/ml,(228.76±60.83)pmol/L]were higher than those in the control group[(214.66±45.89)μg/L,(20.15±4.03)pg/ml,(2.58±0.84)ng/ml,(57.76±18.14)pmol/L](P<0.05).Serum levels of MMP-9,MMP-2,TLR4,and HE4 in NSCLC patients with low-differentiation and lymph node metastasis in TNM stagesⅢtoⅣwere higher than those in patients with medium-differentiation and no lymph node metastasis in TNM stagesⅠtoⅡ(P<0.05).According to ROC analysis,the areas under the curve of serum MMP-9,MMP-2,TLR4 and HE4 for the single diagnosis of NSCLC were 0.790(95%CI:0.690-0.890),0.804(95%CI:0.703-0.904)and 0.813(95%CI:0.703-0.904).0.813(95%CI:0.715-0.912),0.817(95%CI:0.720-0.914),the sensitivity was 0.650(95%CI:0.596-0.712),0.800(95%CI:0.724-0.870),0.750(95%CI:0.724-0.870),0.750(95%CI:0.689-0.834),0.775(95%CI:0.703-0.852),the specificity was 0.825(95%CI:0.763-0.884),0.750(95%CI:0.688-0.825),0.825(95%CI:0.778-0.871),0.800(95%CI:0.734-0.846);The combined diagnosis of NSCLC with serum MM

关 键 词：非小细胞肺癌 基质金属蛋白酶9 基质金属蛋白酶2 TOLL 样受体4 人附睾蛋白4 诊断 

分 类 号：R734.2[医药卫生—肿瘤]