小细胞肺癌诊断因素与全身骨显像骨转移之间的关系

Relationship between diagnostic factors of small cell lung cancer and osseous metastasis of whole body bone imaging

目的:探讨小细胞肺癌诊断因素与全身骨显像骨转移之间的关系。方法:回顾性分析189例小细胞肺癌患者的相关肿瘤标志物及全身骨显像,以全身骨显像为诊断骨转移的金标准,采用SPSS软件中的Pearson卡方分析和Logistic二分类回归方法对小细胞肺癌诊断因素与骨转移的相关性进行分析,用比值比(OR)表示。结果:①单因素Pearson卡方分析显示:癌胚抗原(CEA)、肺门淋巴节均与骨转移无关(x^2=1.101,x^2=0.742;P>0.05);糖链抗原(CA125)、神经特异性烯醇化酶(NSE)、胃泌素释放肽前体(ProGRP)以及碱性磷酸酶(ALP)均与骨转移有相关性(x^2=7.691,x^2=5.439,x2=8.891,x^2=10.030;P<0.05);②二分类logistic分析结果显示:NSE、ALP及肺门淋巴节与骨转移相关(OR=1.010,OR=1.013,OR=3.482;P<0.05),OR均>1是骨转移的危险因素;CA125和ProGRP,虽然P<0.05,但OR=1,表明与骨转移无关;在CEA中OR<1,不是骨转移的危险因素(OR=0.980,P=0.000)。结论:NSE、ALP是骨转移的危险因素,肺门淋巴节、ProGRP与骨转移有一定关系;CA125与骨转移无关;CEA不是小细胞肺癌骨转移的危险因素。

Objective: To investigate the relationship between the diagnostic factors of small cell lung cancer and osseous metastasis by using bone imaging. Methods: The data of the relative tumor marker and whole body bone imaging of 189 patients with small cell lung cancer were analyzed retrospectively. And the results of whole body bone imaging were used as the gold standard for diagnosing osseous metastasis. One-factor Pearson Chi-square analysis and Binary Logistic regression were used to analyze correlation between diagnostic factors of small cell lung cancer and osseous metastasis, and odds ratio was adopted to express the results. Results:①The result of one-factor Pearson Chi-square analysis indicated that there was no significant correlation between osseous metastasis and CEA, Hilar lymph node (x2=1.101, x^2=0.742, P>0.05), while CA125, NSES, ProGRP and ALP were correlative with osseous metastasis (x^2=7.691, x2=5.439, x2=8.891, x^2=10.030, P<0.05), respectively.②The results of Binary Logistic regression analysis indicated that NSE, ALP, Hilar lymph node were correlative with osseous metastasis (OR=1.010, OR=1.013, OR=3.482, P<0.05), and all of their OR were larger than 1, so they were one risk factor of osseous metastasis, respectively. Although the P values of CA125, ProGRP were lower than 0.05, the results of OR=1 meant they were no correlative with osseous metastasis. In the result of CEA, its' OR was less than 1, that meant it was not risk factor of osseous metastasis (OR=0.980, P=0.000). Conclusion: NSE and ALP are risk factors for osseous metastasis in small cell lung cancer. And Hilar lymph node and ProGRP have a certain relationship with osseous metastasis. CA125 is not associated with osseous metastasis. And CEA is not a risk factor for osseous metastasis of small cell lung cancer.