骨肿瘤患者β-CTX、PINP和骨钙素变化及临床意义探讨  

Changes and clinical significance ofβ-CTX,PINP and osteocalcin in patients with bone tumor

作　　者：綦珂 丁薇 童文文 薛晨晨 李朔 QI Ke;DING Wei;TONG Wen-wen(The First Affiliated Hospital of Naval Medical University,Shanghai 200433,China)

机构地区：[1]海军军医大学第一附属医院关节骨病外科,上海200433

出　　处：《临床和实验医学杂志》2024年第23期2510-2513,共4页Journal of Clinical and Experimental Medicine

基　　金：国家自然基金委员会青年项目(编号:81901654)。

摘　　要：目的探讨骨肿瘤患者血清Ⅰ型胶原羧基端肽β特殊序列(β-CTX)、Ⅰ型前胶原氨基端延长肽(PINP)和骨钙素水平变化及临床意义。方法回顾性选取2021年5月至2024年5月海军军医大学第一附属医院收治的106例骨肿瘤患者为研究组,按照病理检查结果将研究组患者进一步分为恶性组(n=30)、中间型组(n=36)和良性组(n=40);另选取同期年龄、性别、体重指数和受教育年限相匹配的60名健康体检者为对照组。比较各组别之间血清β-CTX、PINP和骨钙素水平,采用受试者操作特征(ROC)曲线分析血清β-CTX、PINP和骨钙素水平单独及联合检测对恶性骨肿瘤的诊断效能。结果研究组血清β-CTX和骨钙素水平分别为(534.98±62.78)pg/mL、(20.68±4.12)ng/mL,均高于对照组[(284.07±56.80)pg/mL、(7.37±1.46)ng/mL],血清PINP水平为(27.69±5.52)μg/L,低于对照组[(33.60±6.70)μg/L],差异均有统计学意义(P<0.05)。恶性组血清β-CTX和骨钙素水平分别为(568.30±74.65)pg/mL、(27.20±5.43)ng/mL,均高于中间型组[(535.65±52.20)pg/mL、(20.80±4.15)ng/mL]和良性组[(509.38±45.46)pg/mL、(15.68±3.11)ng/mL],血清PINP水平为(23.40±4.67)μg/L,低于中间型组[(26.50±5.20)μg/L]和良性组[(31.97±6.38)μg/L],差异均有统计学意义(P<0.05);中间型组血清β-CTX和骨钙素水平均高于良性组,血清PINP水平低于良性组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,血清β-CTX、PINP和骨钙素水平对恶性骨肿瘤均有一定诊断效能,曲线下面积分别为0.725、0.710和0.760,敏感度分别为0.765、0.744和0.767,特异度分别为0.623、0.684和0.702;3项指标联合诊断恶性骨肿瘤的曲线下面积为0.862,敏感度为0.884,特异度为0.807。结论骨肿瘤患者血清β-CTX和骨钙素水平明显升高,血清PINP水平明显降低,三者联合检测对恶性骨肿瘤具有较高的诊断效能,值得临床验证。Objective To investigate the changes of serum typeⅠcollagen carboxyterminal peptideβ-specific sequence(β-CTX),typeⅠprocollagen N-terminal propeptide(PINP)and osteocalcin levels and their clinical significance in patients with bone tumors.Methods A total of 106 patients with bone tumors admitted to the First Affiliated Hospital of Naval Medical University from May 2021 to May 2024 were retrospectively selected as the study group,and the patients in the study group were further divided into the malignant group(n=30),the intermediate group(n=36)and the benign group(n=40)according to the pathological examination results.Another 60 healthy subjects during the same period matching age,sex,body mass index and years of education were selected as the control group.Serumβ-CTX,PINP and osteocalcin levels were compared between groups,and receiver operating characteristic(ROC)curves were used to analyze the diagnostic efficacy of serumβ-CTX,PINP,and osteocalcin levels alone and in combination for malignant bone tumors.Results The levels of serumβ-CTX and osteocalcin in the study group were(534.98±62.78)pg/mL and(20.68±4.12)ng/mL,respectively,which were higher than those in the control group[(284.07±56.80)pg/mL and(7.37±1.46)ng/mL],the serum PINP level was(27.69±5.52)μg/L,which was lower than that in the control group[(33.60±6.70)μg/L],and the differences were statistically significant(P<0.05).The levels of serumβ-CTX and osteocalcin in the malignant group were(568.30±74.65)pg/mL and(27.20±5.43)ng/mL,respectively,which were higher than those in the intermediate group[(535.65±52.20)pg/mL and(20.80±4.15)ng/mL]and the benign group[(509.38±45.46)pg/mL and(15.68±3.11)ng/mL],the level of serum PINP was(23.40±4.67)μg/L,which was lower than that of the intermediate type group[(26.50±5.20)μg/L]and the benign group[(31.97±6.38)μg/L],and the differences were statistically significant(P<0.05);the levels of serumβ-CTX and osteocalcin in the intermediate group were higher than those of in the benign group,whil

关 键 词：骨肿瘤 骨钙素 Ⅰ型胶原羧基端肽β Ⅰ型前胶原氨基端延长肽 

分 类 号：R73[医药卫生—肿瘤]