生物标志物的联合检测对矽肺早期辅助诊断的价值

Usefulness of combined application of biomarkers in early auxiliary diagnosis of silicosis

目的:探讨联合检测生物标志物应用于矽肺早期辅助诊断的灵敏度和特异性。方法:采用立意抽样法,选取65例男性矽肺患者为病例组,以70例接触游离二氧化硅的在岗作业人员为对照组。清晨空腹采集外周血并分离血清,采用比色法测定对照人群和矽肺患者血清中超氧化物歧化酶(SOD)和丙二醛(MDA)水平;酶联免疫吸附法测定白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平,以矽肺I期患者血清中有显著性变化的生物标志物(MDA、IL-6和TNF-α)检测数据为数据集,绘制受试者工作特征曲线(ROC)并建立Logistic回归模型,评估联合检测上述生物标志物对矽肺早期辅助诊断的价值。结果:与对照组相比,矽肺患者血清中SOD表达水平无显著变化(P>0.05);矽肺Ⅰ期及Ⅱ期患者血清中MDA及IL-6表达水平显著升高(P<0.05);矽肺Ⅰ期患者血清中TNF-α表达水平显著升高(P<0.05)。回归模型结果显示,ROC曲线下面积排序为:3个指标联合检测(0.89)>IL-6(0.86)>MDA(0.81)>TNF-α(0.65)。结论:IL-6、TNF-α和MDA的联合检测可以提高矽肺早期辅助诊断的灵敏度和特异性。

OBJECTIVE:To explore the value of combined-biomarker detection method in early auxiliary diagnosis of silicosis.METHODS:Sixty-five silicosis male patients were chosen as the patient group,and seventy male workers without SiO2 dust exposure were selected as the control group by purposive method.Peripheral blood was collected from all subjects during the early morning before they had breakfast.Serum was separated from the blood samples.Levels of superoxide dismutase(SOD) and malondialdehyde(MDA) were determined by the colorimetric method,and levels of interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) were measured by enzyme-linked immunosorbent assay(ELISA).Taking the biomarkers(MDA,IL-6 and TNF-α) with significant changes in the serum of patients with stage Ⅰ silicosis as the data set,ROC curves were drawn and the logistic regression model was used to evaluate the value of the combined biomarkers for early auxiliary diagnosis of silicosis.RESULTS:Compared with the control group,the SOD contents had no significant changes in the serum of patients with silicosis,while the MDA and IL-6 contents were significantly increased,and the TNF-α contents were significantly increased in the stage Ⅰ silicosis patients.The results showed that the area under ROC curve was combined application(0.89)>IL-6(0.86)>MDA(0.81)>TNF-α(0.65).CONCLUSION:The combined application of IL-6,TNF-α and MDA improved the sensitivity and specificity of early auxiliary diagnosis of silicosis.