血清TEM8、HMGA1、CST1联合检测在肺结节良恶性诊断中的临床价值  

Clinical value of combined detection of serum TEM8,HMGA1,and CST1 in the diagnosis of benign and malignant pulmonary nodules

作　　者：马秀玲 李林 王超 李健[1] 赵莉[1] MA Xiuling;LI Lin;WANG Chao;LI Jian;ZHAO Li(Department of Thoracic Surgery,First Hospital of Qinhuangdao,Qinhuangdao,Hebei 066000,China)

机构地区：[1]秦皇岛市第一医院胸外科,河北秦皇岛066000

出　　处：《临床肺科杂志》2025年第3期397-401,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨血清肿瘤血管内皮标志物8(TEM8)、高迁移率组蛋白A1(HMGA1)、半胱氨酸蛋白酶抑制剂1(CST1)联合检测在肺结节良恶性诊断中的临床价值。方法选取2023年5月至2024年4月本院收治的98例肺结节患者为研究对象,根据病理结果将其分为良性结节组(n=34)和恶性结节组(n=64)。比较两组患者临床资料;采用酶联免疫吸附试验(ELISA)检测血清TEM8、HMGA1、CST1水平;多因素Logistic回归分析恶性肺结节发生的影响因素;绘制受试者工作特征(ROC)曲线评估血清TEM8、HMGA1、CST1对良恶性肺结节的鉴别诊断价值。结果良性结节组和恶性结节组患者结节密度、结节形态比例比较,差异具有统计学意义(P<0.05);恶性结节组血清TEM8、HMGA1、CST1水平均明显高于良性结节组(P<0.05);血清TEM8(OR=1.346、95%CI=1.058~1.713)、HMGA1(OR=1.439、95%CI=1.050~1.973)、CST1(OR=1.652、95%CI=1.121~2.435)水平升高是恶性肺结节发生的独立危险因素(均P<0.05);血清TEM8、HMGA1、CST1三者单独及联合诊断恶性肺结节的曲线下面积(AUC)分别为0.810(95%CI:0.718~0.882)、0.842(95%CI:0.754~0.908)、0.818(95%CI:0.727~0.889)、0.954(95%CI:0.892~0.986),联合优于单独诊断(Z_(联合-TEM8)=3.110,P=0.002,Z_(联合-HMGA1)=3.028,P=0.003,Z_(联合-CST1)=3.341,P=0.001)。结论血清TEM8、HMGA1、CST1水平联合检测对良恶性肺结节具有较高鉴别诊断价值。Objective To investigate the clinical value of the combined detection of serum tumor endothelial marker 8(TEM8),high mobility group protein A1(HMGA1),and cystatin 1(CST1)in the diagnosis of benign and malignant pulmonary nodules.Methods A total of 98 patients with pulmonary nodules admitted to our hospital from May 2023 to April 2024 were regarded as the study subjects,and they were separated into benign nodules group(n=34)and malignant nodules group(n=64)according to the pathological results.The clinical data of the two groups were compared.Enzyme-linked immunosorbent assay(ELISA)was used to detect serum levels of TEM8,HMGA1,and CST1.Multivariate logistic regression analysis was performed to analyze the influencing factors of malignant pulmonary nodules.The receiver operating characteristic(ROC)curve was plotted to evaluate the differential diagnostic value of serum TEM8,HMGA1,and CST1,in benign and malignant pulmonary nodules.Results There were statistically great differences in nodule density and nodule morphology between benign and malignant nodule groups(P<0.05).The serum levels of TEM8,HMGA1,and CST1 in the malignant nodule group were greatly higher than those in the benign nodule group(P<0.05).Elevated serum levels of TEM8(OR=1.346,95%CI=1.058~1.713),HMGA1(OR=1.439,95%CI=1.050~1.973),and CST1(OR=1.652,95%CI=1.121~2.435)were independent risk factors for the occurrence of malignant pulmonary nodules(all P<0.05).The area under the curve(AUC)of serum TEM8,HMGA1 and CST1 alone and in combination in the diagnosis of malignant pulmonary nodules was 0.810(95%CI:0.718~0.882),0.842(95%CI:0.754~0.908),0.818(95%CI:0.727~0.889)and 0.954(95%CI:0.892~0.986),respectively,combined diagnosis was superior to individual diagnosis(Z_(combination-TEM8)=3.110,P=0.002,Z_(combination-HMGA1)=3.028,P=0.003,Z combination-CST1=3.341,P=0.001).Conclusion The combined detection of serum TEM8,HMGA1,and CST1 levels has a high differential diagnostic value for benign and malignant pulmonary nodules.

关 键 词：肺结节 肿瘤血管内皮标志物8 高迁移率组蛋白A1 半胱氨酸蛋白酶抑制剂1 良恶性诊断 

分 类 号：R73[医药卫生—肿瘤]