硫氧还蛋白还原酶在肺癌临床检测中应用

Application of thioredoxin reductase in clinical detection of lung cancer

目的探讨血浆硫氧还蛋白还原酶(TR)在肺癌临床检测中的应用价值。方法选取连云港市第一人民医院自2019年4至2020年5月收治的125例肺癌患者为研究对象。测定患者血浆中TR活性水平,并比较肺癌患者TR活性在不同病理类型、分期、转移方面的差异。以受试者工作特征曲线(ROC)评估TR与癌胚抗原(CEA)在肺癌诊疗方面的检测效果以及联合检测的灵敏度。结果肺鳞癌、肺腺癌、小细胞肺癌患者血浆TR活性比较,差异无统计学意义(P>0.05);Ⅰ&Ⅱ分期肺癌患者的TR活性显著低于Ⅲ&Ⅳ期,未转移肺癌患者的TR活性显著低于转移肺癌患者,差异均有统计学意义(P<0.05)。ROC曲线分析显示,TR的ROC曲线下面积(AUC)、特异度、敏感度分别为0.776、0.649、0.794,CEA的AUC、特异度、敏感度分别为0.669、0.750、0.585。TR的AUC及敏感度高于CEA,差异有统计学意义(P<0.05)。TR+CEA两项指标联合检测AUC为0.925,显著高于TR与CEA单独检测,差异有统计学意义(P<0.05)。结论TR作为一种新的诊断性肿瘤标志物,可用于肺癌早期检测,提示病情进展。TR与CEA联合检测可明显提高肺癌患者的检测敏感度。

Objective To evaluate the clinical value of thioredoxin reductase(TR)in the clinical detection of lung cancer.Methods A retrospective study was performed on 125 cases of patients with lung cancer who were admitted from April 2019 to May 2020.The level of TR activity in plasma was measured,and the differences of TR activity in different pathological types,stages and metastasis of lung cancer patients were compared.Receiver operating characteristic(ROC)curve was used to evaluate the detection effect of TR and carcinoembryonic antigen(CEA)in diagnosis and treatment of lung cancer.Results There was no significant difference in plasma TR activity among patients with lung squamous cell carcinoma,lung adenocarcinoma and small cell lung cancer(P>0.05).TR activity in patients with stage I&II lung cancer was significantly lower than that in patients with stage III&IV,and that in patients with non metastatic lung cancer was significantly lower than that in patients with metastatic lung cancer(P<0.05).ROC curve analysis showed that the area under the ROC curve(AUC),specificity and sensitivity of TR were 0.776,0.649 and 0.794,respectively,while the AUC,specificity and sensitivity of CEA were 0.669,0.750 and 0.585,respectively.The AUC and sensitivity of TR were higher than CEA,P<0.05.The AUC of TR+CEA combined test was 0.925,significantly higher than that of TR and CEA single test,P<0.05.Conclusion As a new diagnostic tumor marker,TR can be used for early detection of lung cancer to indicate disease progression.The combined detection of TR and CEA can significantly improve the detection sensitivity of lung cancer patients.