血清生长分化因子15水平在肺癌的诊断及化疗疗效评估中的价值研究

发布时间：2018-04-26 21:24

  本文选题：肺肿瘤 + 生长分化因子　； 参考：《中国全科医学》2017年15期

【摘要】：目的探讨血清生长分化因子15(GDF-15)水平在肺癌的诊断及化疗疗效评估中的价值,为临床提供参考。方法选取2015年12月—2016年8月就诊于安徽医科大学第一附属医院呼吸内科符合纳入标准的肺癌患者88例、肺炎患者31例以及来自本院体检中心的健康者41例,分别作为肺癌组、肺炎组和正常对照组。检测患者入院时、健康者体检第1天时血清GDF-15水平,同时收集肺癌组患者吸烟情况、合并糖尿病情况、实验室检查指标[血红蛋白(HGB)、前清蛋白(PA)、乳酸脱氢酶(LDH)]、病理学特征(T分期、N分期、临床分期、病理类型);收集肺炎组、肺癌组患者血清GDF-15、癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段(CYFRA21-1)水平,绘制其诊断肺癌的受试者工作特征(ROC)曲线。观察连续2个化疗周期后肺癌组患者的临床疗效,并检测其血清GDF-15水平,分析血清GDF-15水平评估不同化疗疗效的价值。结果肺炎组、肺癌组血清GDF-15水平高于正常对照组(P0.05);肺癌组血清GDF-15水平高于肺炎组(P0.05)。体质指数≥24 kg/m~2肺癌组患者血清GDF-15水平高于体质指数24 kg/m~2者,合并糖尿病肺癌组患者血清GDF-15水平高于无糖尿病者,血清HGB水平低于正常的肺癌组患者血清GDF-15水平高于血清HGB水平正常者(P0.05)。T_(1~2)期肺癌组患者血清GDF-15水平低于T_(3~4)期者(P0.05)。血清GDF-15水平诊断肺癌的截断值为1 199.05 ng/L,其灵敏度为78.2%,特异度为71.0%,ROC曲线下面积(AUC)为0.851[95%CI(0.774,0.910)],约登指数为0.492。血清CEA、NSE、CYFRA21-1水平诊断肺癌的AUC分别为0.630[95%CI(0.537,0.717)]、0.720[95%CI(0.631,0.799)]和0.654[95%CI(0.561,0.739)]。血清GDF-15水平诊断肺癌的AUC大于血清CEA、NSE、CYFRA21-1水平诊断肺癌的AUC(P0.05)。肺癌组64例患者完成连续2个化疗周期,其中部分缓解11例、疾病稳定33例、疾病进展20例。化疗后不同疗效肺癌组患者血清GDF-15、CEA水平比较,差异有统计学意义(P0.05);化疗后不同疗效肺癌组患者血清NSE、CYFRA21-1水平比较,差异无统计学意义(P0.05)。结论血清GDF-15水平可作为筛查肺癌的血清标志物,且有望成为化疗疗效评价的新指标。
[Abstract]:Objective to investigate the value of serum GDF-15 level in the diagnosis of lung cancer and the evaluation of chemotherapeutic efficacy. Methods from December 2015 to August 2016, 88 patients with lung cancer, 31 patients with pneumonia and 41 healthy people from the physical examination center of Anhui Medical University were selected as lung cancer group. Pneumonia group and normal control group. At the first day of physical examination, the serum GDF-15 level was measured, and the smoking status and diabetes mellitus were collected in lung cancer group. Laboratory examination index [HGB, PAP, LDH], pathological features, T staging, clinical stage, pathological type; collecting pneumonia group, collecting pneumonia group, collecting pneumonia group, collecting pneumonia group, collecting pneumonia group, collecting pneumonia group, collecting pneumonia group, collecting pneumonia group, collecting pneumonia group, collecting pneumonia group, collecting pneumonia group, collecting pneumonia group, Serum levels of GDF-15, carcinoembryonic antigen (CEA), neuron-specific enolase (NSEE) and cytokeratin 19 fragment (CYFRA21-1) in patients with lung cancer were determined. To observe the clinical curative effect of lung cancer patients after two consecutive chemotherapy cycles, to detect the serum GDF-15 level and to analyze the value of serum GDF-15 level in evaluating the different chemotherapeutic effects. Results the serum GDF-15 level in lung cancer group was higher than that in normal control group (P 0.05), and the serum GDF-15 level in lung cancer group was higher than that in pneumonia group (P 0.05). The serum GDF-15 level in patients with BMI 鈮，

本文编号：1807754