肺癌患者血清载脂蛋白C1水平及临床意义

Serum apolipoprotein C1 level in patients with lung cancer and its clinical significance

目的分析肺癌患者血清载脂蛋白C1(APOC1)水平,并探讨其临床意义。方法采用酶联免疫吸附试验检测100例健康体检者(健康对照组)、103例肺部良性疾病患者(肺良性疾病组)和360例肺癌患者(肺癌组)血清APOC1水平。采用χ^(2)检验分析血清APOC1水平与肺癌患者临床病理特征的相关性。采用受试者工作特征曲线(ROC曲线)评估APOC1单独及联合癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)和神经元特异性烯醇化酶(NSE)检测对肺癌的诊断价值。结果肺癌组血清APOC1水平高于肺良性疾病组和健康对照组,差异有统计学意义(P<0.05)。根据血清APOC1中位水平对肺癌患者进行分层发现,血清APOC1≥54.46μg/mL患者中TNM分期为Ⅲ~Ⅳ期、低分化、有淋巴结转移和有远处转移的例数明显多于APOC1<54.46μg/mL患者,差异有统计学意义(P<0.05)。APOC1的诊断效能高于CEA、CYFRA21-1和NSE,在APOC1最佳诊断截断值为46.71μg/mL时,其诊断肺癌和早期肺癌的曲线下面积(AUC)分别为0.812和0.766;灵敏度分别为70.3%和60.7%;特异度均为81.0%。4项标志物联合检测时,诊断肺癌和早期肺癌的AUC分别增加至0.902和0.860。结论肺癌患者血清APOC1水平明显升高,可能是肺癌潜在的诊断指标。血清APOC1水平对于肿瘤分期、分化程度、淋巴结转移和远处转移具有潜在的预测价值。APOC1、CEA、CYFRA21-1及NSE联合检测可提高肺癌诊断的准确度。

Objective To analyze the level of apolipoprotein C1(APOC1)in the serum of patients with lung cancer and explore its clinical significance.Methods The enzyme-linked immunosorbent assay was used to detect the serum APOC1 levels of 100 healthy subjects(healthy control group),103 patients with benign lung disease(benign lung disease group)and 360 patients with lung cancer(lung cancer group).Theχ^(2) test was used to analyze the correlation between serum APOC1 level and clinicopathological characteristics of lung cancer patients.Used receiver operating characteristic curve(ROC curve)to evaluate the diagnostic value of APOC1 alone and in combination with carcinoembryonic antigen(CEA),cytokeratin 19 fragment(CYFRA21-1)and neuron-specific enolase(NSE)for lung cancer.Results The level of serum APOC1 in lung cancer group was higher than that in benign lung disease group and healthy control group,and the differences were statistically significant(P<0.05).Lung cancer patients were layered based on the median serum APOC1 level,then found that the number of tumor stage atⅢ-Ⅳ,poor differentiation,lymph node metastasis and distant metastasis in APOC1≥54.46μg/mL patients was significantly more than the number in APOC1<54.46μg/mL patients,the differences were statistically significant(P<0.05).The diagnostic efficiency of APOC1 was higher than that of CEA,CYFRA21-1 and NSE.When the best diagnostic cut-off value of APOC1 was 46.71μg/mL,the area under the curve(AUC)for the diagnosis of lung cancer and early lung cancer were 0.812 and 0.766,respectively;the sensitivity were 70.3%and 60.7%,respectively;the specificity were all 81.0%.When the four markers were combined detection,the AUC for the diagnosis of lung cancer and early lung cancer increased to 0.902 and 0.860,respectively.Conclusion Serum level of APOC1 is significantly increased in patients with lung cancer,which could be a potential indicator for the diagnosis of lung cancer.Serum level of APOC1 has potential predictive value for tumor stage,degree of differentiation,lymph node metastasis and distant metastasis.The combined detection of APOC1,CEA,CYFRA21-1 and NSE could improve the accuracy of lung cancer diagnosis.