追踪监测脱氧吡啶啉诊断肺癌骨转移的意义

Track study in deoxypyridinoline on diagnose osseous metastasis of lung neoplasms

目的探讨尿脱氧吡啶啉(uDPD)对肺癌骨转移诊断的意义。方法 182例肺癌患者分骨转移组和未发现骨转移组,进行 uDPD/尿肌酐(uCr)比值、尿钙(uCa)/uCr、血清钙(sCa)、血清碱性磷酸酶(sAKP)比较,并对其在肺癌骨转移诊断的灵敏度、特异度作比较。同时,对其中80例肺癌未发现骨转移患者进行6个月的追踪观察。结果肺癌骨转移组 uDPD/Cr 为[(12.35±2.65)nmoL/mmo1],高于肺癌未发现骨转移组[(7.76±2.11)nmol/mmol,t=2.46,P<0.01];其诊断肺癌骨转移的灵敏度、特异度分别为81.4%和70%;80例肺癌无骨转移患者初测 uDPD/uCr 比值正常组6个月后骨转移率为17.4%,初测 uDPD/uCr 比值升高组6个月后骨转移率为55.9%;两组差异有统计学意义(X^2=12.95,P<0.01)。结论 uDPD 对肺癌骨转移诊断和与监测有较大临床意义。

Objective To explore the significance of urine deoxypyridinoline to diagnosis on osseous metastasis of lung neoplasms. Methods .182 cases with lung carcinoma was divided into two groups. One group was case with osseous metastasis, the other group was case without osseous metastasis, uDPD/uCr, uCa/Cr, sCa and sAKP in two groups were respectively compared. Sensitivity and specificity of these indexes to diagnosis on osseous metastasis of lung cancer were also acalculated and compared. 80 cases without osseous metastasis were follow-up for 6 months. Results The ratio of uDPD/uCr with osseous metastasis group [ （12. 35 ±2.65） nmol/mmol] was significantly higher than that of without osseous metastasis group [ （ 7. 76 ± 2. 11 ） nmol/mmol ] （ t = 2. 46, P 〈 0. 01 ）. Sensitivity and specificity of uDPD/uCr to diagnosis on osseous metastasis of lung cancer were 81.4% and 70%, respectively. Osseous metastasis occurred in 17.4% of cases with normal uDPD/uCr but in 55.9% of cases with high uDPD/uCr the difference of occurrence of osseous metastasis between normal and higher uDPD/uCr was statistically significant （Χ^2 = 12.95 ,P 〈 0. 01 ）. Conclusion uDPD has a significant impact on early diagnosis and surveillance on osseous metastasis of lung neoplasms.