纤维蛋白原降解产物EXY在肺癌诊断中的应用价值

Clinical significance of fibrinogen degradation products EXY for the diagnosis of lung cancer

目的探讨纤维蛋白原降解产物(FDP)中3个常见片段EXY在肺癌(LC)诊断中的应用价值。方法根据病理结果将224例LC可疑患者分为LC组(n=132)和阴性对照(NC)组(n=92),NC组为肺炎或肺部良性肿瘤患者。另选择同期86例健康体检者作为健康对照组。检测并比较3组研究对象的血浆EXY水平。结合EXY、癌胚抗原(CEA)、血清总胆红素(STB)、年龄4个特征变量,采用线性回归分析,构造一个新的变量LC-预测因子,分析其对LC的诊断价值。比较术前和术后LC患者的血浆EXY水平。结果LC组患者的血浆EXY水平高于健康对照组和NC组,差异均有统计学意义(P﹤0.05)。0期LC患者的血浆EXY水平高于Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者,差异均有统计学意义(P﹤0.05)。利用LC-预测因子诊断LC,曲线下面积(AUC)增加到0.741;尤其对于年龄≤60岁的人群,AUC上升至0`.781。术后LC患者的血浆EXY水平高于术前,差异有统计学意义(P﹤0.05)。结论FDP EXY在LC的诊断中具有一定的临床意义,血浆EXY水平随LC的发生、进展和手术治疗而发生变化。

Objective To investigate the value of three common fragments EXY in fibrinogen degradation product(FDP)in the diagnosis of lung cancer(LC).Method According to pathology results,224 cases with suspected LC were included in the analysis as LC group(n=132)or negative control(NC)group(n=92)that involved patients with pneumonia or pulmonary benign lesions.Another 86 healthy volunteers were recruited as healthy control group.The levels of EXY in plasma of the three groups were detected and compared.Combining EXY,carcinoembryonic antigen(CEA),serum total bilirubin(STB),and age,a novel variable named LC-predictor was constructed using linear regression analysis,to determine the diagnostic value of the new variable.Besides,the level of plasma EXY in LC patients before and after surgery were compared.Result The LC group showed a significantly enhanced EXY level compared with healthy control group and NC group,the differences were statistically significant(P<0.05).LC patients of stage 0 had significantly higher plasma EXY compared to patients with stage I,II,or III,IV diseases(P<0.05).LC-predictor was used to diagnose LC,exhibiting an increase in area under the curve(AUC)to 0.741;for subjects≤60 years of age in particular,the AUC further elevated to 0.781.Post-operative plasma EXY levels in LC patients were higher after surgery,with statistically significant change noted(P<0.05).Conclusion FDP EXY is clinically significant in the diagnosis of LC,besides,plasma EXY level fluctuates along with the occurrence,development and surgical procedures of LC.