肺癌患者血清MIC-1升高的临床价值

Clinical Value of Serum MIC-1 Level in Patients with Lung Cancer

目的研究巨噬细胞抑制因子-1(MIC-1)血清水平在肺癌诊断中的临床应用价值。方法采用双抗体夹心ELISA法检测256例肺癌患者、44例肺良性疾病患者及229例正常对照人群血清MIC-1浓度,采用电化学发光免疫分析仪及化学发光免疫分析仪分别检测肺癌患者血清CEA、CA125、NSE、CYFRA21-1和SCC浓度。结果肺癌组患者血清中MIC-1浓度显著高于正常对照组(P<0.001)和肺良性疾病组(P<0.001);根据ROC曲线和正常人群的MIC-1血清水平,设1000pg/mL为诊断肺癌的临界值,MIC-1检测肺癌的敏感性和特异性分别为69.5%和96.5%;在不同病理类型中,血清MIC-1对小细胞癌的诊断敏感性高于鳞癌和腺癌,低分化组患者血清MIC-1水平明显高于高分化+中分化组(P<0.05);MIC-1诊断肺癌的敏感性优于已有标志物CEA、CA125、NSE、SCC和CYFRA21-1;在肺癌早期(I期和II期)阶段,MIC-1诊断敏感性优于五种标志物的联合诊断(I期:66.7%vs 50.0%,II期:72.7%vs 69.0%);六种标志物联合诊断则能使I期和II期肺癌诊断敏感性分别提高至77.1%和85.5%。结论本研究在较大样本量中证实MIC-1在肺癌诊断中的临床应用价值,提示其可能成为比较理想的肺癌诊断及筛查标志物。

Objective To study the clinical value of serum macrophages inhibitory cytokine-1 （MIC-1） level in patients with lung cancers.Methods The double antibody sandwich ELISA was used to detect serum MIC-1level in 256 lung cancer patients,44 benign pulmonary disease patients and 229 healthy persons.ELCIA and CLIA were used to detect the serum CEA,CA125,NSE,CYFRA21-1 and SCC level.Results MIC-1concentration in lung cancer group was significantly higher than that in normal control group （P ＜ 0.001） and benign disease group （P ＜ 0.001）.According to ROC curve and MIC-1 level of normal control group,the cut-off value of MIC-1 was set at 1000pg/mL,the specificity and sensitivity were 96.5％ and 69.5％ respectively.In different subtypes of lung cancer,the sensitivity of serum MIC-1 was highest in SCLC group than squamous-cell carcinoma and adenocarcinoma groups.The serum level of MIC-1 was higher in low differentiation group than high differentiation and differentiated groups （P ＜ 0.05）.The sensitivity of MIC-1 for early stage lung cancer was higher than CEA,CA125,N SE,SCC and CYFRA21-1 respectively.The sensitivity of MIC-1 for early stage lung cancer （stage I and stage Ⅱ） was higher than the combination of the above five markers（stage I：66.7％ vs 50.0％ ;stage Ⅱ：72.7％ vs 69.0％）.The sensitivity of MIC-1 for stage I and stage Ⅱ was improved to 77.1％ 85.5 ％ respectively in the combination of the six markers.Conclusion The present study is to confirm excellent clinical value of MIC-1 in a large sample of lung cancer.MIC-1 may be a new serum marker for lung cancer diagnosis.