摘要
目的观察老年肺腺癌患者血清甘露糖结合凝集素相关丝氨酸蛋白酶-2(mannose-binding lectin associated serine protease-2,MASP-2)、半乳糖凝集素-3(galectin-3,Gal-3)表达情况,探讨其对老年肺腺癌患者淋巴结转移的预测价值。方法117例老年肺腺癌患者均行手术治疗及术后组织病理检查,根据淋巴结转移情况分为转移组30例和未转移组87例,比较2组患者临床资料,采用电化学发光免疫分析法检测患者术前血清癌胚抗原、糖类抗原125水平,采用ELISA法检测患者术前血清MASP-2、Gal-3水平,采用一般线性双变量Spearman直线相关性分析老年肺腺癌患者血清MASP-2、Gal-3水平与癌胚抗原、MASP-2与Gal-3的相关性;绘制ROC曲线,评估术前血清MASP-2、Gal-3水平预测老年肺腺癌患者淋巴结转移的效能。结果117例老年肺腺癌患者30例发生淋巴结转移,发生率为25.64%;转移组术前血清癌胚抗原[22.54(19.31,24.65)μg/L]、糖类抗原125[40.12(38.05,44.47)u/mL]、MASP-2[377.63(372.91,388.86)μg/L]、Gal-3[3.77(3.42,4.58)μg/L]水平均高于未转移组[15.28(12.89,18.61)μg/L、35.08(33.96,37.03)u/mL、361.32(357.35,369.21)μg/L、2.85(2.33,3.46)μg/L](P<0.05);老年肺腺癌患者血清MASP-2、Gal-3水平与癌胚抗原均呈正相关(r=0.292,P=0.001;r=0.307,P=0.001),血清MASP-2水平与Gal-3呈正相关(r=0.194,P=0.036);术前血清MASP-2、Gal-3水平的最佳截断值分别为366.24μg/L、3.18μg/L时,单独及联合检测预测老年肺腺癌患者淋巴结转移的AUC分别为0.875(95%CI:0.800~0.951,P<0.001)、0.870(95%CI:0.805~0.936,P<0.001)、0.903(95%CI:0.836~0.970,P<0.001),灵敏度分别为86.7%、90.0%、93.3%,特异度分别为69.0%、62.1%、57.5%。结论老年肺腺癌淋巴结转移患者血清MASP-2、Gal-3水平增高,早期监测患者血清MASP-2、Gal-3水平对预测肺腺癌淋巴结转移有一定价值。
Objective To observe the expressions of serum mannose-binding lectin associated serine protease-2(MASP-2)and galectin-3(Gal-3)in elderly patients with lung adenocarcinoma,and to explore their values to the prediction of lymph node metastasis.Methods Totally 117 elderly patients with lung adenocarcinoma received histopathological examination after operation,and were divided into metastasis group(n=30)and non-metastasis group(n=87).The clinical data were compared between two groups.The preoperative serum levels of carcinoembryonic antigen(CEA)and carbohydrate antigen 125(CA125)were detected by electrochemiluminescence immunoassay,and the preoperative serum levels of MASP-2 and Gal-3 were detected by ELISA.General linear bivariate Spearman linear correlation test was done to analyze the correlations of MASP-2 and Gal-3 with CEA as well as the correlation of MASP-2 with Gal-3.ROC curve was drawn to evaluate the efficiencies of preoperative MASP-2 and Gal-3 levels on predicting lymph node metastasis in elderly patients with lung adenocarcinoma.Results Among 117 elderly patients with lung adenocarcinoma,30 cases(25.64%)had lymph node metastasis.The preoperative serum levels of CEA,CA125,MASP-2 and Gal-3 were higher in metastasis group[22.54(19.31,24.65)μg/L,40.12(38.05,44.47)u/mL,377.63(372.91,388.86)μg/L,3.77(3.42,4.58)μg/L]than those in non-metastasis group[15.28(12.89,18.61)μg/L,35.08(33.96,37.03)u/mL,361.32(357.35,369.21)μg/L,2.85(2.33,3.46)μg/L](P<0.05).The serum levels of MASP-2 and Gal-3 were positively correlated with CEA(r=0.292,P=0.001;r=0.307,P=0.001),and serum MASP-2 level was positively correlated with Gal-3(r=0.194,P=0.036).When the optimal cut-offvalues of preoperative MASP-2 and Gal-3 were 366.24 and 3.18μg/L,the AUCs of the single and combined detection of MASP-2 and Gal-3 for predicting lymph node metastasis in elderly patients with lung adenocarcinoma were0.875(95%CI:0.800-0.951,P<0.001),0.870(95%CI:0.805-0.936,P<0.001)and 0.903(95%CI:0.836-0.970,P<0.001),the sensitivities were 86.7%,90.0%and 93.3%,and the specificities were 69.0%,62.1%and 57.5%,respectively.Conclusion The serum levels of MASP-2 and Gal-3 increase in elderly patients with lung adenocarcinoma when lymph node metastasis occurs,and early monitoring of serum levels of MASP-2 and Gal-3 has a certain value to the prediction of lymph node metastasis.
作者
阿衣夏木古丽·艾则孜
刘洪柏
马丽丽
韩忠诚
Ayixiamuguli AIZEZI;LIU Hong-bai;MA Li-li;HAN Zhong-cheng(Department of Oncology,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang Uygur Autonomous Region 830001,China)
出处
《中华实用诊断与治疗杂志》
2021年第12期1198-1201,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
新疆维吾尔自治区自然科学基金(2018D01C743)。
