肺癌患者血清和支气管分泌物中HE4蛋白水平改变及临床意义研究

Clinical value of serum and bronchial aspiration fluid HE-4 levels in patients with lung cancer

目的:探讨肺癌患者血清和支气管分泌物中人类附睾4蛋白(HE-4)的表达水平,以及对肺癌早期诊断价值和临床意义。方法:将入选的患者分为肺癌组(58例),肺部良性病变组(40例),比较两组血清和支气管分泌物中HE-4的水平,通过受试者工作曲线(ROC)分析血清HE-4用于诊断肺癌患者的价值,并进一步采用Spersman方法对血清HE-4水平与临床资料的相关性进行分析。结果:肺癌患者和肺良性病变患者支气管分泌物中HE-4水平比较,差异无统计学意义(P>0.05),而两组血清中HE-4表达水平比较,差异具有统计学意义(P<0.05);血清HE-4用于诊断肺癌的曲线下面积(AUC)为0.798(P<0.05),最佳截断值为68.9pg/mL,诊断的敏感性为82%,特异性为65%,支气管分泌物HE-4对诊断肺癌的AUC为0.598(P>0.05),差异无统计学意义;相关性分析可见血清HE-4水平与肺癌TNM分期、淋巴结转移和远处转移情况存在一定的相关性(P<0.05)。结论:血清HE-4水平较支气管分泌物中升高更具临床意义,对诊断肺癌具有一定的临床意义,且可能与肺癌的转移有一定相关性。

Objective： To evaluate the clinical value of serum and bronchial aspiration fluid HE-4 levels in patients with lung cancer . Methods： A total of 58 patients with lung cancer and 40 with benign lung disease were enrolled in our study. Ser- um and bronchial aspiration fluid HE-4 levels were compared between the two group. The specificity and sensitivity of serum and bronchial aspiration fluid HE-4 levels were analyzed by ROC curve analysis. Spearman was used to evaluate the association of clinical and pathologic features with levels of LYVE-1. Results： Serum HE-4 levels were significantly higher in patients with lung cancer group than in benign lung disease group （P（0.05）. No significant difference was observed in terms of BAF HE-4 values in two patient groups（P〉0.05）. The areas under the receiver operating characteristic （ROC） curve of serum HE-4 was 0. 798 [95% confidence interval （CI） ,0. 685-0. 741] and that of BAF HE-4 was 0. 598 （95% CI, 0. 345-0. 680）. A high canc- er staging, occurrence of lymph-node metastases, and occurrence of distant metastases patient were associated with highHE-4levels（P〈0.05）. No significant difference was observed in sex, tumor location and tumor histology. Conclusion： The increase of level of serum HE-4 is more prominent than the increase of the level of BAF HE 4 , and it has certain clinical significance for diagnosis of lung cancer and occurrence of metastases.