ⅠCTP诊断肺癌骨转移的初步研究

Preliminary results of use of serum ⅠCTP for diagnosing bone metastasis in patients with lung cancer

目的 :评价ⅠCTP诊断肺癌早期骨转移的效能。方法 :用放免法测定 86例肺癌患者和 3 0例健康者血清ⅠCTP浓度 ,并随访半年至 2年。结果 :骨转移者血清ⅠCTP ( 7.2 4± 3 .0 9μg/L )明显高于无骨转移 ( 4 .19±2 .4 9μg/L ,P <0 .0 0 1)和健康者 ( 3 .83± 1.0 7μg/L ,P <0 .0 0 1)。ICTP、核素骨显像诊断肺癌骨转移的准确性(ROC曲线下的面积 )、灵敏度和特异度分别为 :0 .82、0 .74 (P <0 .0 5 ) ;86%、80 % ;81%、72 %。Logistic回归分析 ,ⅠCTP、核素骨显像与骨转移的相关系数分别为 :r=0 .3 8,P <0 .0 0 5 ;r=0 .2 5 ,P <0 .0 5。随访发现ⅠCTP随骨转移的范围增多而增高。结论 :ⅠCTP是诊断肺癌早期骨转移的良好标志物 ,有助于随访和监测肺癌骨转移 ,能早于骨显像发现骨转移。若ⅠCTP低于正常值则骨转移的可能性相当低 。

Objectives: To evaluate the diagnostic efficacy of Carboxyterminal cross linked telopeptide of typeⅠcollagen(ⅠCTP) for detection of early bone metastases of lung cancer. Methods: A radioimmunoassay was employed for determination of ⅠCTP concentrations in serum using a TELOPEPTIDE ⅠCTP( 125I) Raidioimmunoassay Kit (Finland).We have evaluated 86 lung cancer patients and 30 healthy controls with follow up 6 month to two years. Results: ⅠCTP serum concentrations in patients(7.24±3.09 μg/L) with bone metastasis was higher than those in patients (4.19± 2.49 μg/L ) without bone metastasis( P < 0.001) and in healthy controls (3.83±1.07 μg/L )( P < 0.001).The accuracy(as assessed by the area under the receiver operating characteristic curve)was higher for ⅠCTP(0.82) than for bone scintigraphy (0.74). The correlation was higher between ⅠCTP and bone metastasis(r=0.38 P < 0.005) than between bone scintigraphy and bone metastasis (r=0.25, P < 0.05). The sensitivity (86%) and specificity (80%) of ⅠCTP was superior to that of bone scintigraphy (81%,72%). Conclusion: ⅠCTP could be a good indicator for early diagnosis of bone metastasis in lung cancer patient, and it could be helpful in the follow up and in monitoring for bone metastasis of lung cancer. It could detect bone metastasis earlier than bone scintigraphy. A normal result of this assay indicates a very low probability of bone metastasis, while high value ICTP indicating a high possibility of bone metastasis.