N-Osrteoc、β-Crosslaps、TPINP在鼻咽癌放疗后骨转移中诊断及预后中的价值

The value of N-Osrteoc,β-Crosslaps and TPINP in the diagnosis and prognosis of bone metastases after radiotherapy for nasopharyngeal carcinoma

目的探究N端骨钙素(N-Osrteoc)、β-胶原特殊系列(β-Crosslaps)、总Ⅰ型胶原氨基端延长肽(TPINP)在鼻咽癌放疗后骨转移中诊断及预后中的价值。方法选取本院2015年3月至2018年3月鼻咽癌放疗后骨转移患者89例作为转移组,放疗后未发生骨转移患者37例作为未转移组。比较两组临床资料、血清N-Osrteoc、β-Crosslaps、TPINP水平,采用Pearson相关性分析转移组血清N-Osrteoc、β-Crosslaps、TPINP与常规肿瘤标志物相关性,受试者工作特征(ROC)曲线评价上述指标诊断价值,随访2年,统计转移组2年生存率,并采用Kaplan-Meier曲线进行生存分析。结果转移组血清N-Osrteoc、β-Crosslaps、TPINP水平高于未转移组(P<0.05);血清N-Osrteoc、β-Crosslaps、TPINP与CEA、CYFRA21-1呈正相关(P<0.05);血清N-Osrteoc、β-Crosslaps、TPINP水平联合检测诊断鼻咽癌放疗后骨转移的AUC最大,为0.872,敏感度为82.02%,特异度为83.78%;血清N-Osrteoc、β-Crosslaps、TPINP高危患者2年生存率低于低危患者(P<0.05)。结论临床可通过监测N-Osrteoc、β-Crosslaps、TPINP水平评估鼻咽癌患者放疗后骨转移情况,有利于为患者预后评估提供参考依据。

Objective To explore the value of N-terminal osteocalcin(N-Osrteoc),β-collagen special series(β-Crosslaps),and total type I collagen N-terminal extension peptide(TPINP)in the diagnosis and prognosis of bone metastases after radiotherapy for nasopharyngeal carcinoma.Methods From March2015 to March 2018 in our hospital,89 patients with bone metastasis after radiotherapy for nasopharyngeal carcinoma were selected as the metastasis group,and 37 patients without bone metastasis after radiotherapy were selected as the non-metastasis group.The clinical data,serum N-Osrteoc,β-Crosslaps,and TPINP levels were measured and compared between the two groups.Pearson correlation was used to analyze the correlation between serum N-Osrteoc,β-Crosslaps,TPINP and conventional tumor markers in the metastasis group.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of the above indicators,followed up for 2 years,the 2-year survival rate of the metastasis group was counted,and the Kaplan-Meier curve was used for survival analysis.Results The levels of serum N-Osrteoc,β-Crosslaps and TPINP in the metastasis group were higher than those in the non-metastasis group(P<0.05).Serum N-Osrteoc,β-Crosslaps,TPINPwere positively correlated with CEA and CYFRA21-1(P<0.05).The combined detection of serum N-Osrteoc,β-Crosslaps,and TPINP levels in the diagnosis of bone metastases after radiotherapy for nasopharyngeal carcinoma has the largest AUC of 0.872,sensitivity of 82.02%,and specificity of 83.78%.The2-year survival rate of high-risk patients with serum N-Osrteoc,β-Crosslaps,and TPINP was lower than that of low-risk patients(P<0.05).Conclusion Monitoring the levels of N-Osrteoc,β-Crosslaps,and TPINP can be used to assess bone metastasis in patients with nasopharyngeal carcinoma after radiotherapy,which is helpful to provide a reference for the prognosis evaluation of patients.