血清同型半胱氨酸与唾液酸联合检测在鼻咽癌诊断中的应用

Application of serum homocysteine and sialic acid in the diagnosis of nasopharyngeal carcinoma

目的探讨同型半胱氨酸（Hcy）和唾液酸（SA）在鼻咽癌（NPC）诊断中的应用价值。方法选取经病理检查确诊的NPC患者60例作为NPC组,选择该院保健科健康体检者77例作为健康对照组。采用循环酶法检测Hcy水平,酶法测定SA水平,对两组Hcy、SA水平进行比较并进行相关性分析,就NPC患者的阳性率进行比较,绘制受试者工作特征曲线（ROC曲线）,比较Hcy和SA与NPC的关系及临床应用价值。结果 （1）分别比较两组血清Hcy和SA水平,NPC组Hcy水平（22.78±6.81）μmol/L较健康对照组（12.75±4.27）μmol/L明显增高,差异有统计学意义（P〈0.05）;NPC组SA水平（77.88±15.18）mg/L较健康对照组（60.91±9.52）mg/L亦明显增高,差异也有统计学意义（P〈0.05）。（2）Hcy和SA的ROC曲线下面积分别为0.903和0.849,对NPC诊断均有显著意义（P=0.000）。（3）血清Hcy和SA间有一定正相关关系（r=0.318,P〈0.05）;血清Hcy和SA对NPC的阳性检出率分别为85.00%和53.33%,单项检测与二者联合检测对NPC诊断阳性检出率差异有统计意义（χ^2=32.85,P=0.000）。结论血清Hcy和SA检测对NPC的诊断均具有临床意义,且二者有一定的正相关性;联合检测可提高NPC的诊断性能。

Objective To investigate the value of homocysteine（Hcy）and sialic acid（SA）in the diagnosis of nasopharyngeal carcinoma（NPC）.Methods Sixty cases of NPC patients confirmed by pathology were identified as NPC group,and 77 healthy persons were taken as normal control group.The level of Hcy was measured by cyclic enzyme method,the level of SA was determined by enzyme method,the two groups of Hcy,SA were compared and the correlation analysis was carried on,the positive rate of NPC patients were compared to draw the receiver operating characteristic（ROC）curve,the positive rate of NPC patients were compared,drawing the curve of the receiver operating characteristic,comparison of the relationship between Hcy and SA and NPC and its clinical application value.Results（1）Hcy level（22.78±6.81）μmol/L in NPC group was significantly higher than that in healthy control group（12.75±4.27）μmol/L,and the difference was statistically significant（P〈0.05）;The level of SA in NPC group（77.88±15.18）mg/L was significantly higher than that in healthy control group（60.91±9.52）mg/L,and the difference was statistically significant（P〈0.05）.（2）The area under the ROC curve of Hcy and SA were 0.903 and 0.849,respectively,which were significant for NPC diagnosis（P=0.000）.（3）There was a positive correlation between serum Hcy and SA（r=0.318,P〈0.05）.The positive rate of serum Hcy and SA in NPC was 85.00% and 53.33%,there was significant difference in the positive rate between the single detection and the combined detection of NPC（χ^2=32.85,P=0.000）.Conclusion Detection of serum Hcy and SA in the diagnosis of NPC is of clinical significance,and the two have a certain positive correlation;combined detection can improve the diagnostic performance of NPC.