摘要
目的探讨血清糖类抗原125(CA125)、癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)和系统免疫炎症指数(SII)联合检测对原发性肺癌患者骨转移的预测价值。方法本研究为病例对照研究。采用非随机抽样的方法选取2020年2月至2023年12月在汉中市人民医院就诊的104例原发性肺癌患者。根据是否发生骨转移将患者分为骨转移组(32例)和非骨转移组(72例)。检测所有患者的血清CA125、CEA、NSE水平,以及血清中性粒细胞、淋巴细胞、血小板的数目,并计算SII。比较2组患者的临床资料,包括性别、年龄、身体质量指数、组织病理学亚型、吸烟史、TNM分期、淋巴结转移,以及CA125、CEA、NSE、SII水平。多因素logistic回归分析原发性肺癌患者骨转移的影响因素;绘制受试者操作特征(ROC)曲线评估血清CA125、CEA、NSE、SII和联合检测对原发性肺癌患者骨转移的预测效能。结果骨转移组男22例,女10例,年龄(67.25±9.06)岁。非骨转移组男50例,女22例,年龄(66.28±9.92)岁。2组患者性别、年龄、身体质量指数、组织病理学亚型、吸烟史、TNM分期比较差异均无统计学意义(均P>0.05),淋巴结转移分布比较差异有统计学意义(χ^(2)=4.13,P<0.05)。骨转移组患者血清CA125、CEA、NSE和SII水平均高于非骨转移组患者[(28.17±8.94)U/ml比(15.21±4.87)U/ml、(6.57±2.12)μg/L比(3.49±1.15)μg/L、(11.68±3.34)μg/L比(7.65±1.82)μg/L、(743.90±221.56)比(465.65±131.74)],差异均有统计学意义(t值分别为9.55、9.59、7.95、7.97,均P<0.001)。CA125(OR=2.210,95%CI:1.335~3.657)、CEA(OR=1.917,95%CI:1.209~3.038)、NSE(OR=1.867,95%CI:1.157~3.012)、SII(OR=2.318,95%CI:1.285~4.181)升高是原发性肺癌患者骨转移的独立危险因素(均P<0.05)。ROC曲线结果显示血清CA125、CEA、NSE、SII和联合检测预测原发性肺癌患者骨转移的曲线下面积分别为0.835、0.871、0.872、0.868、0.956。曲线下面积比较结果显示,联合预测优于单独预测(Z值分别为2.71、2.10、2.01、2.14,均P<0.05)。结论血清CA125、CEA、NSE和SII联合检测对原发性肺癌患者骨转移具有较高的预测价值。
Objective To explore the predictive value of a combination detection of serum carbohydrate antigen 125(CA125),carcinoembryonic antigen(CEA),neuron-specific enolase(NSE)and systemic immune inflammatory index(SII)in bone metastasis of primary lung cancers.Methods This study was a case-control study involving 104 patients with primary lung cancers admitted in the Department of Respiratory Medicine of Hanzhong People′s Hospital from February 2020 to December 2023 using a non-random sampling method.They were assigned into bone metastasis group(32 cases)and non-bone metastasis group(72 cases)according to the presence and absence of bone metastasis.Serum CA125,CEA,and NSE levels were detected.Neutrophil,lymphocyte,and platelet counts in the serum were measured,and SII was calculated.The clinical data(gender,age,body mass index,histopathological subtype,smoking history,tumor-node-metastasis[TNM]staging,lymph node metastasis),as well as CA125,CEA,NSE,and SII levels were compared between the two groups.The receiver operating characteristic(ROC)curves were plotted to evaluate the value of a combination detection of serum CA125,CEA,NSE and SII in bone metastasis of primary lung cancers.Results There were 22 males and 10 females in the bone metastasis group,with an average age of 67.25±9.06 years.There were 50 males and 22 females in the non-bone metastasis group,with an average age of 66.28±9.92 years.There were no significant differences in gender,age,body mass index,histopathological subtype,smoking history,and TNM staging between the two groups of patients(all P>0.05).There was a significant difference in the distribution of lymph node metastasis(χ^(2)=4.13,P<0.05).Serum CA125([28.17±8.94]U/ml vs[15.21±4.87]U/ml),CEA([6.57±2.12]μg/L vs[3.49±1.15]μg/L),NSE([11.68±3.34]μg/L vs[7.65±1.82]μg/L)and SII([743.90±221.56]vs[465.65±131.74])levels of patients in the bone metastasis group were significantly higher than those of the non-bone metastasis group(t value was 9.55,9.59,7.95 and 7.97,respectively;all P<0.001).The increases of CA125(OR=2.210,95%CI:1.335,3.657),CEA(OR=1.917,95%CI:1.209,3.038),NSE(OR=1.867,95%CI:1.157,3.012),and SII(OR=2.318,95%CI:1.285,4.181)were risk factors for bone metastasis in patients with primary lung cancers(all P<0.05).The ROC curve results showed that the area under the curve(AUC)of serum CA125,CEA,NSE,SII and a combination detection in predicting bone metastasis in patients with primary lung cancers was 0.835,0.871,0.872,0.868 and 0.956 respectively.The AUC results showed that the combination prediction was better than the single detection(Z value was 2.71,2.10,2.01,and 2.14,respectively;all P<0.05).Conclusions The combination detection of serum CA125,CEA,NSE and SII has a high predictive value for bone metastasis in patients with primary lung cancers.
作者
秦晓娟
袁媛
Qin Xiaojuan;Yuan Yuan(Department of Respiration,Hanzhong People′s Hospital,Hanzhong 723000,China;Department of Integrative Medicine,Shaanxi Provincial Cancer Hospital,Xi′an 710061,China)
出处
《国际呼吸杂志》
2024年第5期563-567,共5页
International Journal of Respiration
关键词
肺肿瘤
癌胚抗原
骨转移
糖类抗原125
神经元特异性烯醇化酶
系统免疫炎症指数
Lung neoplasms
Carcinoembryonic antigen
Bone metastasis
Carbohydrate antigen 125
Neuron-specific enolase
Systemic immune inflammation index
