全身骨显像联合血清N-Osrteoc和VEGFR2检测对老年肺癌患者骨转移的临床诊断价值  

Clinical diagnostic value of whole-body bone imaging combined with serum N-Osrteoc and VEGFR2 detection for bone metastasis in elderly patients with lung cancer

作　　者：冯思源 龙雷[1] 邢拓 于立普[1] 宋其韬[1] 张瑞国[2] FENG Siyuan;LONG Lei;XING Tuo;YU Lipu;SONG Qitao;ZHANG Ruiguo(Nuclear Medicine Department,Tianjin Hospital,Tianjin 300211,China;Nuclear Medicine Department,Tianjin Medical University General Hospital,Tianjin 300052,China)

机构地区：[1]天津医院核医学科,天津300211 [2]天津医科大学总医院核医学科,天津300052

出　　处：《中国医科大学学报》2025年第3期214-218,共5页Journal of China Medical University

基　　金：国家自然科学基金(81801732)。

摘　　要：目的探讨全身骨显像联合血清N端骨钙素(N-Osrteoc)和血管内皮生长因子受体2(VEGFR2)检测对老年肺癌患者骨转移的临床诊断价值。方法回顾性分析2021年12月至2023年12月天津医院首次确诊的100例老年肺癌患者的临床资料,根据病理结果分为肺癌骨转移组(42例)和肺癌无骨转移组(58例)。采用酶联免疫吸附试验(ELISA)检测血清N-Osrteoc和VEGFR2水平,采用SPECT诊断仪对患者进行全身骨显像检查;血清N-Osrteoc、VEGFR2、全身骨显像对肺癌骨转移的诊断价值采用受试者操作特征(ROC)曲线分析;不同检查方法诊断肺癌骨转移与病理诊断结果的一致性采用Kappa检验分析。结果肺癌骨转移组患者血清N-Osrteoc、VEGFR2水平显著高于肺癌无骨转移组(P<0.05)。血清N-Osrteoc、VEGFR2水平、全身骨显像单独及联合诊断肺癌骨转移的曲线下面积(AUC)分别为0.847、0.846、0.907、0.956;与病理结果比较,诊断肺癌骨转移结果假阳性例数分别为14例、19例、8例、1例,假阴性例数分别为7例、7例、2例、3例,一致性Kappa值分别为0.579、0.487、0.799、0.917(P<0.05)。全身骨显像联合血清N-Osrteoc、VEGFR2诊断肺癌骨转移的特异度显著高于单独诊断(P<0.05)。结论全身骨显像联合血清N-Osrteoc、VEGFR2检测对老年肺癌患者骨转移的早期诊断具有重要意义,其联合诊断具有较高的灵敏度和特异度,可在临床中推广使用。Objective To analyze the clinical diagnostic value of whole-body bone imaging combined with serum N-terminal osteocalcin(N-Osrteoc)and vascular endothelial growth factor receptor 2(VEGFR2)for evaluating bone metastasis in elderly patients with lung cancer.Methods General data of 100 elderly patients with lung cancer diagnozed for the first time at Tianjin Hospital between December 2021 and December 2023 were retrospectively collected.Based on the pathological results,the patients were separated into a lung cancer bone metastasis group of 42 cases and a lung cancer non-bone metastasis group of 58 cases.Serum N-Osrteoc and VEGFR2 levels were detected by using an enzyme-linked immunosorbent assay(ELISA).All patients underwent whole-body bone imaging using SPECT diagnostic equipment.Receiver operator characteristic(ROC)curve analysis was performed to determine the diagnostic value of serum N-Osrteoc,VEGFR2,and whole-body bone imaging for lung cancer bone metastasis.Furthermore,Kappa test was performed to analyze the consistency between different examination methods for diagnozing lung cancer bone metastasis and pathological diagnosis results.Results The serum N-Osrteoc and VEGFR2 levels in the bone metastasis group were significantly higher than those in the nonbone metastasis group(P<0.05).The area under the curve(AUC)for serum N-Osrteoc and VEGFR2 levels,whole-body bone imaging,and their combination for diagnozing lung cancer bone metastasis were 0.847,0.846,0.907,and 0.956,respectively.Furthermore,compared with the pathological results,the numbers of false-positive cases were 14,19,8,and 1,those of false-negative cases were 7,7,2,and 3,and the Kappa values were 0.579,0.487,0.799,and 0.917,respectively(P<0.05).The specificity of whole-body bone imaging combined with serum N-Osrteoc and VEGFR2 in diagnozing lung cancer bone metastasis was significantly higher than alone(P<0.05).Conclusion The combination of whole-body bone imaging and serum N-Osrteoc and VEGFR2 levels is of great significance for early diagnosis of

关 键 词：老年肺癌 骨转移 全身骨显像 N端骨钙素 血管内皮生长因子受体2 诊断 

分 类 号：R734.2[医药卫生—肿瘤]