肺癌患者血清ODF和OCIF水平与骨转移的相关性研究

Correlation between serum ODF and OCIF levels in lung cancer patients with bone metastasis

目的:探讨检测破骨细胞分化因子(osteoclast differentiation factor,ODF)和破骨细胞生成抑制因子(osteo-clastogenesis inhibitory factor,OCIF)对肺癌骨转移诊断及病情评价的临床价值。方法:分析2009年7月至2012年4月186例初诊为肺癌患者的资料。肺癌骨转移组和非骨转移组分别为104例和82例,采用ELISA法测定各组血清ODF和OCIF浓度。结果:骨转移组患者血清ODF和OCIF分别为(32.22±6.22)ng/L、(41.23±8.13)ng/L,明显高于非骨转移组的(8.35±5.42)ng/L、(10.15±4.42)ng/L,有显著性差异(P<0.01)。ODF和OCIF诊断肺癌骨转移ROC曲线下面积分别为0.91和0.87,具有良好的诊断价值。诊断肺癌骨转移的灵敏度、特异度,ODF分别为90.38%、86.59%;OCIF分别为86.54%、84.15%。ODF随骨转移部位数量增加而明显升高,OCIF随骨转移部位数量增加而明显降低。新发骨转移组和骨转移组血清ODF和OCIF浓度均显著高于非骨转移组,有显著性差异(P<0.01);新发骨转移组血清ODF和OCIF浓度与骨转移组比较,两组间无显著性差异(P>0.05)。结论:肺癌患者发生骨转移时,血清和含量明显增高,可作为判断肺癌患者骨转移及监测病情的参考指标,在临床上有广泛的应用前景。

Objective： This study was aimed to investigate the value ofosteoclast differentiation factor （ODF） and osteoclastogenesis inhibitory factor （OCIF） detection for clinical diagnosis and assessment of patient condition in bone metastasis of lung cancer. Methods： Data from 186 lung cancer patients who were preliminary diagnosed between July 2009 and April 2012 were analyzed. Cases were divided into the bone metastasis group with 82 cases （group A） and the non-bone metastasis group with 104 cases （group B）. Concentrations of serum ODF and OCIF in each group were detected by ELISA. Results： ODF and OCIF values of group A were （32.22±6.22） ng/L and （41.23：±8.13） ng/L, respectively, which were significantly higher than the corresponding values in group B [（8.35 ±5.42） ng/L and （10.15±4.42） ng/L]. The differences between the two groups were statistically significant （P〈0.01）. Areas under the receiver operating characteristic curves of ODF and OCIF, which are used to diagnose bone metastasis in lung cancer were 0.91 and 0.87, respectively, manifesting good diagnostic value. The sensitivity and specificity of ODF in diagnosing lung cancer with bone metastasis were 90.38% and 86.59%, respectively, and those of OCIF were 86.54% and 84.15%, respectively. ODF increased, whereas OCIF decreased significantly, with increasing bone metastasis. ODF and OCIF concentrations in group A and the group with newly-found bone metastasis were significantly higher than those in group B, with statistically significant differences among these groups （P〈0.01）. Compared with group A, less difference was found in the ODF and OCIF of newly-found bone metastases, without statistical significance between these groups （P〉0.05）. Conclusion： The serum ODF and OCIF concentrations significantly increase when bone metastasis occurs in lung cancer patients. Hence, these variables are useful as indices for monitoring bone metastases and evaluating patient condition. An extensive application prospect is proposed.