肺癌患者血清碱性磷酸酶、神经元特异性烯醇化酶水平及其与骨转移的相关性

Serum Alkaline Phosphatase,Neuron Specific Enolase Levels in Lung Cancer Patients and Their Correlation with Bone Metastasis

目的观察肺癌患者血清碱性磷酸酶(ALP)、神经元特异性烯醇化酶(NSE)水平,并分析其与骨转移的关系。方法选取2018年1月至2021年10月商丘市第四人民医院收治的105例肺癌患者为研究对象,以骨穿刺活检为金标准评估患者骨转移发生情况,将发生骨转移患者纳入骨转移组,未发生骨转移患者纳入非骨转移组;所有患者于病理学检查确诊为肺癌时行血清ALP、NSE检查,比较两组患者血清ALP、NSE水平及基线资料情况,分析血清ALP、NSE与肺癌患者骨转移的关系以及二者对肺癌患者骨转移的评估价值。结果纳入的105例肺癌患者中,有39例发生骨转移,发生率为37.14%;骨转移组血清ALP、NSE水平高于非骨转移组(P<0.05);经logistic回归分析,结果显示,血清ALP(OR=1.105,95%CI:1.057~1.155)、NSE(OR=1.488,95%CI:1.205~1.837)过表达与肺癌患者发生骨转移有关(P<0.05);绘制受试者工作特征(ROC)曲线,结果显示,血清ALP、NSE单独及联合评估肺癌患者骨转移发生风险的曲线下面积(AUC)分别为0.828、0.780、0.864(95%CI分别为0.743~0.912、0.688~0.872、0.789~0.939,P<0.05),评估价值较理想,且以联合评估价值最佳。结论肺癌骨转移患者血清ALP、NSE呈高表达,未来可考虑早期监测肺癌患者血清ALP、NSE表达评估骨转移发生风险。

Objective To observe serum alkaline phosphatase(ALP),neuron specific enolase(NSE)levels in patients with lung cancer,and to analyze its relationship with bone metastasis.Methods A total of 105 patients with lung cancer treated in Shangqiu Fourth People’s Hospital from January 2018 to October 2021 were selected as the research subjects.Bone biopsy was used as the“gold standard”to evaluate the occurrence of bone metastasis of patients.Patients with bone metastasis were included in the bone metastasis group,and patients without bone metastasis were included in the non bone metastasis group.All patients were examined for serum ALP and NSE when they were diagnosed as lung cancer by pathological examination,the levels of serum ALP and NSE and baseline data of patients in both groups were compared.The relationship between serum ALP,NSE and bone metastasis in patients with lung cancer and evaluation value of the two methods for bone metastases was analyzed.Results Among 105 included patients with lung cancer,39 cases had bone metastasis,the incidence rate was 37.14%.The levels of serum ALP and NSE in bone metastasis group were higher than those in non bone metastasis group(P<0.05).The results of logistic regression analysis showed that,the overexpression of serum ALP(OR=1.105,95%CI:1.057-1.155)and NSE(OR=1.488,95%CI:1.205-1.837)were related to bone metastasis in patients with lung cancer(P<0.05).The receiver operating characteristic(ROC)curve was drawn,and the results showed that the area under the curve(AUC)of serum ALP and NSE alone and in combination for evaluating the risk of bone metastasis in patients with lung cancer were 0.828,0.780 and 0.864 respectively(the 95%CI of were 0.743-0.912,0.688-0.872 and 0.789-0.939,respectively,P<0.05),the appraisal value was ideal,and the joint appraisal value was the best.Conclusion Serum ALP and NSE is high expressed in patients with bone metastasis of lung cancer,which can be used as an index to evaluate the occurrence of bone metastasis in patients with lung cancer.