不同生物标志物联合诊断骨肉瘤的价值

Diagnostic value of different biomarkers in the diagnosis of osteosarcoma

目的:探究不同生物标志物在骨肉瘤患者中的表达水平及诊断价值。方法:对2014年5月至2017年12月在本院就诊的56例骨肉瘤患者(骨肉瘤组)、62例良性骨科增生患者(良性疾病组)及62例健康体检者(对照组)进行分析,比较3组之间T细胞免疫球蛋白黏蛋白分子3(Tim-3)、miRNA-21(miR-21)、碱性磷酸酶(ALP)及乳酸脱氢酶(LDH)水平差异,并以ROC曲线评价其单独及联合诊断的诊断效能。结果:3组患者的Tim-3、miR-21、ALP及LDH水平间差异有统计学意义(P<0.05)。ROC曲线显示,Tim-3及miR-21联合诊断的AUC为0.929,显著高于单独诊断(P<0.05);Tim-3、miR-21、ALP、LDH水平的最佳截点分别为12.37 ng·ml^-1、1.60拷贝·μl^-1、239.84 U·L^-1、266.91 U·L^-1,联合诊断的敏感性及阳性预测值均显著高于单独诊断(P<0.05)。结论:Tim-3及miR-21联合诊断骨肉瘤具有较高的价值,其中ρ(Tim-3)≥12.37 ng·ml^-1、miR-21水平≥1.60拷贝·μl^-1可以作为骨肉瘤筛查截点。

Objective: To explore the clinical value of different biomarkers in the diagnosis of osteosarcoma.Methods: 56 patients with osteosarcoma from May 2014 to December 2017 diagnosed in our hospital(osteosarcoma group),62 patients with orthopedic benign hyperplasia(benign disease group) and 62 cases of healthy subjects(control group) within the same period of time and of age were selected.T cell immunoglobulin and mucin domain-3(Tim-3),microRNA-21(miR-21),alkaline phosphatase(ALP),lactate dehydrogenase(LDH) level in the three groups were comparatively analyzed,receiver operating curve(ROC) was drawn and the diagnostic efficacy of Tim-3,miR-21,ALP,LDH alone and in combination with the diagnosis of osteosarcoma were evaluated.Results:There was a statistically significant difference in levels of Tim-3,miR-21,ALP,LDH in the three groups(P <0.05).The ROC curve showed that the AUC of combined Tim-3 and miR-21 was 0.929,it was significantly higher than that of single diagnosis.The optimal cut-off point of Tim-3 was 12.37 ng·ml^-1,miR-21 was 1.60 copies· μl^-1,ALP was 239.84 U · L^-1,LDH was 266.91 U · L^-1.Using the above cut-off points,the sensitivity and positive predictive value of combined diagnosis were significantly higher than single diagnosis(P <0.05).Conclusion: Tim-3 combined with miR-21 has a higher value in the diagnosis of osteosarcoma,wherein Tim-3≥12.37 ng·ml^-1,miR-21≥1.60 copies·μl^-1 can be regarded as the best cut-off point for osteosarcoma screening.