血清TSGF、SCCAg及MMP3联合检测在鼻咽癌诊断中的临床价值

Clinical value of combined detection of serum TSGF,SCCAg and MMP3 in diagnosis of nasopharyngeal carcinoma

目的探究血清恶性肿瘤相关物质(TSGF)、鳞癌抗原(SCCAg)及基质金属蛋白酶3(MMP3)联合检测在鼻咽癌诊断中的应用价值。方法选择2015年3月至2019年12月成都市双流区中医医院收治的102例鼻咽癌患者纳入鼻咽癌组,另择同期收治的50例鼻咽炎患者及100例健康体检者纳入鼻咽炎组及对照组,收集鼻咽癌患者临床资料,测定各组受试者血清TSGF、SCCAg及MMP3水平。结果(1)鼻咽癌患者血清TSGF、SCCAg及MMP3水平显著高于鼻咽炎组、对照组(P<0.05)。(2)血清TSGF、SCCAg与患者病理诊断类型、T分期、TNM分期相关(P<0.05),血清MMP3与鼻咽癌患者T分期、N分期及TNM分期相关(P<0.05)。(3)血清TSGF、SCCAg及MMP3单独诊断鼻咽癌的曲线下面积(AUC)分别为0.793、0.775、0.658,其中TSGF诊断AUC最大,当截点值为68.30U/mL时,约登指数最大;外周血TSGF联合SCCAg、TSGF联合MMP3、SCCAg联合MMP3、三者联合诊断鼻咽癌的AUC分别为0.847、0.805、0.801、0.857,其中三者联合诊断效能最高。结论鼻咽癌患者可伴有血清TSGF、SCCAg及MMP3的升高,三者均对鼻咽癌有一定诊断价值,两者联合及三者联合诊断效能更高,临床可根据情况选择多个指标辅助诊断。

Objective To explore the application value of combined detection of serum tumor supplied group of factors(TSGF),squamous cell carcinoma antigen(SCCAg)and matrix metalloproteinase 3(MMP3)in diagnosis of nasopharyngeal carcinoma.Methods 102 patients with nasopharyngeal carcinoma who were admitted to Chinese Medicine Hospital of shuangliu District between March 2015 and December 2019 were selected and included in the nasopharyngeal carcinoma group.Meanwhile,50 patients with nasopharyngitis and 100 healthy controls were selected and included in the nasopharyngitis group and control group,respectively.The clinical data of patients with nasopharyngeal carcinoma were collected,and serum TSGF,SCCAg and MMP3 levels in each group were determined.Results(1)Serum TSGF,SCCAg and MMP3 levels in nasopharyngeal carcinoma were significantly higher than those in nasopharyngitis group and control group(P<0.05).(2)Serum TSGF and SCCAg were correlated with the type,T stage and TNM stage diagnosed by pathology(P<0.05).Serum MMP3 was correlated with T stage,TNM stage and N stage of nasopharyngeal carcinoma(P<0.05).(3)The area under the curve(AUC)of serum TSGF,SCCAg and MMP3 for diagnosing nasopharyngeal carcinoma alone was 0.793,0.775 and 0.658,respectively.Besides,the AUC of TSGF was the largest,and when the cut-off value was 68.30 U/mL,the Youden index was the largest.The AUC values of serum TSGF combined with SCCAg,TSGF combined with MMP3,SCCAg combined with MMP3,and the combination of the three for diagnosing nasopharyngeal carcinoma were 0.847,0.805,0.801 and 0.857,respectively.Conclusion Patients with nasopharyngeal carcinoma may be accompanied by elevated serum TSGF,SCCAg and MMP3.The three indexes have certain value for diagnosing nasopharyngeal carcinoma.The combination of two or three of them is more effective in diagnosis.Multiple indexes can be used to help diagnosis according to the specific condition.