血清钙离子、碱性磷酸酶及肿瘤标志物在肺癌骨转移预测分析

Predictive value of serum calcium ion, ALP and routine six tumor markers in bone metastasis of lung cancer

目的观察血清Ca2+、ALP及肿瘤标志物在肺癌骨转移预测价值。方法选取236例中晚期肺癌病例(本院2016年1月至2018年12月收治)作为研究对象,所有病例均于确诊时行血清Ca2+、ALP及肿瘤标志物检测进行骨转移预测。统计所有病例1年时病理检查肺癌细胞骨转移情况,分析非骨转移与骨转移病例、不同骨转移soloway程度分级病例的血清Ca2+、ALP及肿瘤标志物水平差异,分析其在肺癌骨转移中的预测效能。结果 236例肺癌中晚期病例中,158例(66.95%)未发生骨转移,78例(33.05%)发生骨转移,其中骨转移M1、M2、M3分别39例(16.53%)、21例(8.90%)、18例(7.62%)。非骨转移病例的Ca2+、ALP及肿瘤标志物均低于骨转移病例(P<0.05)。随着骨转移soloway程度分级提升,Ca2+、ALP及肿瘤标志物均提升(P<0.05)。Ca2+、ALP及肿瘤标志物联合的预测敏感性(90.17%)、预测特异性(92.18%)、预测准确率(94.18%)均高于各单项指标的预测敏感性(73.15%~86.15%)、预测特异性(73.86%~88.91%)、预测准确率(73.14%~88.12%)(P<0.05)。结论血清Ca2+、ALP及肿瘤标志物均在肺癌骨转移预测中具有重要的价值,且联合应用可进一步提升预测敏感性、预测特异性和预测准确性。

Objective To observe the predictive value of serum Ca2+, ALP and tumor markers in bone metastasis of lung cancer. Methods 236 cases of middle-late stage lung cancer in our hospital from January 2016 to December 2018 were selected as the research object, and all cases were confirmed in their serum Ca2+, ALP and bone metastases tumor markers to predict bone metastases. The situation of bone metastases from lung cancer was analyzed during 1 year follow-up, in order to analyze the differences in serum Ca2+, ALP and tumor markers between bone metastases patients and non bone metastases patients. Results Among the 236 patients with middle and advanced lung cancer, 158(66.95%) had no bone metastasis and 78(33.05%) had bone metastasis, among which 39(16.53%) had bone metastasis M1, M2, M3, 21(8.90%), and 18(7.62%) had non-bone metastasis. The levels of Ca2+, ALP and tumor markers were lower in non bone metastases patients than those in bone metastasis patients(P<0.05), and they increased with the soloway grading of bone metastases. The combined prediction sensitivity(90.17%), specificity(92.18%) and prediction accuracy(94.18%) were higher than that of each single indicator’s sensitivity(73.15%~86.15%), specificity(73.86%~88.91%) and accuracy(73.14%~88.12%)(P<0.05). Conclusion Serum Ca2+, ALP and tumor markers have important value in the prediction of bone metastasis of lung cancer, and the combined application can further improve the prediction sensitivity, specificity and accuracy.