矽肺患者血清神经元特异性烯醇化酶的变化

Changes of neuron specific enolase in serum of patients with silicosis

目的探讨矽肺患者血清中神经元特异性烯醇化酶(NSE)浓度的变化及相应的临床意义。方法于2020年1月,选择2018年1月至2019年12月在烟台市烟台山医院确诊的矽肺患者455例,另选择同期健康体检者60例、肺癌患者120例作为健康组和肺癌组。以化学免疫荧光法检测受试者血清中NSE水平并进行比较分析。结果矽肺组血清NSE水平为[(22.88±7.86)ng/ml],高于健康组[(17.96±4.42)ng/ml],差异有统计学意义(P<0.05)。矽肺壹期、贰期、叁期组血清NSE水平均高于健康组,差异有统计学意义(P<0.05),但不同期别矽肺组间差异无统计学意义(P>0.05)。矽肺组血清NSE水平低于小细胞肺癌组,差异有统计学意义(P<0.05),与非小细胞肺癌组差异无统计学意义(P>0.05)。血清NSE对矽肺的诊断曲线下面积为0.718(P<0.01),当血清NSE的诊断阈值为17.49 ng/ml时,其诊断的敏感度为78%,特异度为57%。结论矽肺患者血清NSE水平明显增高,可作为矽肺诊断及鉴别诊断的重要参考指标。

Objective To explore the changes of neuron specific enolase(NSE)concentration in serum samples of patients with silicosis.Methods In January 2020,455 cases of silicosis diagnosed in Yantaishan Hospital from January 2018 to December 2019 were collected,and 60 healthy cases and 120 cases of lung cancer were selected as the healthy group and the lung cancer group.The serum levels of NSE were detected by chemical immunofluorescence assay and compared.Results The serum NSE level of silicosis patients was[(22.88±7.86)ng/ml],higher than that of healthy group[(17.96±4.42)ng/ml](P<0.05).Serum NSE levels in the first,second and third stage silicosis groups were higher than those in the healthy group(P<0.05),but there was no statistically significant difference between the silicosis groups at different periods(P>0.05).The serum NSE level of silicosis patients was lower than that of the small cell lung cancer group(P<0.05),but there was no statistically significant difference between silicosis group and non-small cell lung cancer group(P>0.05).The area under curve of silicosis NSE was 0.718(P<0.01)when the cut-off was 17.49 ng/ml,the sensitivity and specificity of NSE was 78%and 57%respectively.Conclusion The serum NSE level of patients with silicosis is significantly increased,which can be used as an important reference index for the diagnosis and the differential diagnosis of silicosis.