血清学标志物在恶性肿瘤骨转移筛查中的应用价值研究  

Study on the application value of serological markers in the screening of malignant tumor bone metastasis

作　　者：丁霏 王心仪 贺勇[1] 聂鑫[1] 李贵星[1] DING Fei;WANG Xinyi;HE Yong;NIE Xin;LI Guixing(Department of Experimental Medicine,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]四川大学华西医院实验医学科,四川成都610041

出　　处：《国际检验医学杂志》2025年第3期308-313,共6页International Journal of Laboratory Medicine

摘　　要：目的 探讨血清学标志物在恶性肿瘤骨转移筛查中的应用价值。方法 选取2023年6月至2024年2月于该院首次诊断为恶性肿瘤骨转移患者113例作为病例组。另选取同期在该院确诊的恶性肿瘤无骨转移患者80例作为对照组。比较两组血清学标志物[血清钙(Ca)、甲状旁腺激素(PTH)、Ca/PTH、Ⅰ型前胶原氨基端肽(P1NP)、β-I型胶原羧基末端肽(β-CTX)及骨钙素N端中分子片段]水平。绘制受试者工作特征(ROC)曲线,分析血清学标志物在肺癌、前列腺癌及乳腺癌骨转移中的筛查价值。采用多因素Logistic回归分析恶性肿瘤骨转移发生的相关因素。结果 病例组Ca、Ca/PTH、β-CTX及P1NP水平明显高于对照组,病例组PTH低于对照组,差异均有统计学意义(P<0.05)。ROC曲线结果显示,Ca、PTH、Ca/PTH、P1NP及β-CTX对于筛查恶性肿瘤骨转移效能较高,曲线下面积(AUC)分别为0.718、0.699、0.712、0.648及0.593。多因素Logistic回归分析结果显示,Ca/PTH及P1NP是恶性肿瘤发生骨转移的影响因素(OR=5.036、1.013,P<0.05)。Ca、PTH和Ca/PTH筛查肺癌骨转移的AUC分别为0.781、0.652和0.669;β-CTX和P1NP筛查前列腺癌骨转移的AUC分别为0.800及0.815;Ca和P1NP筛查乳腺癌骨转移的AUC分别为0.751及0.794。结论 血清学标志物(Ca、PTH、Ca/PTH、P1NP及β-CTX)对恶性肿瘤骨转移有一定的筛查价值。Objective To explore the application value of serological markers in the screening of malignant tumor bone metastasis.Methods A total of 113 patients with malignant tumor bone metastasis first diagnosed in a hospital from June 2023 to February 2024 were selected as case group.Another 80 patients with malignant tumor without bone metastasis diagnosed in the same period were selected as the control group.The levels of serological markers[serum calcium(Ca),parathyroid hormone(PTH),Ca/PTH,procollagen type 1 amino-terminal propeptide(P1NP),beta-C-terminal telopeptide of type 1 collagen(β-CTX)and N-terminal mid-fragment of osteocalcin]were compared between the two groups.Receiver operating characteristic(ROC)curves were plotted to analyze the value of serological markers in screening for bone metastases of lung cancer,prostate cancer and breast cancer.Multivariate Logistic regression was used to analyze the related factors of malignant tumor bone metastasis.Results The levels of Ca,Ca/PTH,β-CTX and P1NP in case group were significantly higher than those in control group,while PTH in case group was lower than that in control group,with statistical significance(P<0.05).ROC curve results showed that Ca,PTH,Ca/PTH,P1NP andβ-CTX had high efficacy in screening malignant tumor bone metastases,and the area under the curve(AUC)was 0.718,0.699,0.712,0.648 and 0.593,respectively.Multivariate Logistic regression analysis showed that Ca/PTH and P1NP were the influencing factors of bone metastasis in malignant tumor(OR=5.036,1.013,P<0.05).The AUC of Ca,PTH and Ca/PTH screening for bone metastasis of lung cancer were 0.781,0.652 and 0.669,respectively.The AUC ofβ-CTX and P1NP screening for bone metastasis of prostate cancer were 0.800 and 0.815 respectively.The AUC of Ca and P1NP screening for breast cancer with bone metastasis was 0.751 and 0.794,respectively.Conclusion Serological markers(Ca,PTH,Ca/PTH,P1NP andβ-CTX)are valuable in screening for malignant tumor bone metastasis.

关 键 词：血清学标志物 恶性肿瘤 骨转移 

分 类 号：R730.4[医药卫生—肿瘤]