PEDF与VEGF检测在非小细胞肺癌诊断中的应用探讨

Diagnostic Value of Detection of Pigment Epithelium-derived Factor and Vascular Endothelial Growth Factor in Non-small Cell Lung Cancer

探讨色素上皮衍生因子(PEDF)与血管内皮生长因子(VEGF)检测对于非小细胞肺癌的诊断价值,并将上述两项指标作比较、联合分析。经应用受试者工作特征曲线分析并选取最佳诊断界值,若以血清PEDF蛋白浓度≤584ng/L为临界值,则其诊断非小细胞肺癌的灵敏度为72.3%,特异度为89.0%,准确度为79.8%;以血清VEGF蛋白浓度≥854ng/L为临界值,则其诊断非小细胞肺癌的灵敏度为80.0%,特异度为76.9%,准确度为78.4%。PEDF与VEGF检测相互串联(即:若血清PEDF蛋白浓度≤584ng/L且血清VEGF蛋白浓度≥854ng/L,则判定为非小细胞肺癌;反之则否),用以诊断非小细胞肺癌的灵敏度57.8%,特异度为97.7%;PEDF与VEGF检测相互并联(即:若血清PEDF蛋白浓度≤584ng/L或血清VEGF蛋白浓度≥854ng/L,则判定为非小细胞肺癌;反之则否),用以诊断非小细胞肺癌的灵敏度为94.5%,特异度为68.4%。血清PEDF或VEGF检测对于非小细胞肺癌诊断可能具有一定的辅助参考价值,上述两项指标联合检测可提高诊断的灵敏度或特异度。

The aim of this study was to primarily evaluate the diagnostic efficiency of detection of pigment epithelium-derived factor （PEDF） and vascular endothelial growth factor （VEGF） in non-small cell lung cancer （NSCLC）, and analyze combination tests if possible. With receiver operating characteristic curve analysis and the optimal cut-off points selected then, the index of diagnostic efficiency of serum PEDF for NSCLC （PEDF≤584ng/L as NSCLC） were： sensitivity 72.3%, specificity 89. 0%, accuracy 79. 8%, while those index of serum VEGF for NSCLC （VEGF≥854ng/L as NSCLC） were： sensitivity 80. 0%, specificity 76. 9%, accuracy 78. 4%. When the above two examinations were combined, the diagnostic sensitivity and specificity of cascade connection test for NSCLC （PEDF≤584ng/L and VEGF≥ 854ng/L as NSCLC） were 57.8% and 97.7%, respectively; while the sensitivity and specificity of parallel test （PEDF≤584ng/L or VEGF≥854ng/L as NSCLC） were 94.50% and 68.4%, respectively. Detection of PEDF or VEGF in serum might be of subsidiary reference value in the diagnosis of NSCLC. Combination tests of the above two index could lead to a higher diagnostic sensitivity or specificity.