血清IL-38,miR-1233水平对中晚期肺癌化疗后近期发生肺栓塞风险的预估价值

Predictive value of serum IL-38 and miR-1233 levels in the risk of short-term pulmonary embolism after chemotherapy in advanced lung cancer

目的探讨血清白细胞介素-38(IL-38),微小核糖核酸-1233(miR-1233)水平对中晚期肺癌化疗后近期发生肺栓塞(PE)风险的预估价值。方法选取2020年5月至2021年5月本院收治的中晚期肺癌化疗患者110例作为本次研究对象,根据患者化疗后3个月内是否发生PE分为PE组、非PE组。统计两组患者临床资料,比较两组血清IL-38、miR-1233水平及其他可导致早期PE影响因素差异,采用Logistic回归分析分析中晚期肺癌患者化疗后发生早期PE的危险因素,采用Pearson法分析患者血清中IL-38和miR-1233表达的相关性;绘制受试者工作特征曲线(ROC)分析血清IL-38、miR-1233对PE中晚期肺癌患者化疗后发生早期PE的预估价值。结果110例中晚期肺癌患者化疗后3个月内PE发生率为51.82%(57/110);单因素分析显示,PE组体质量指数(BMI)、腺癌占比、D-二聚体(D-D)、血清IL-38、血清miR-1233水平高于非PE组(P<0.05);Logistic回归分析显示,D-D、血清IL-38和miR-1233呈高表达水平为中晚期肺癌患者化疗后近期发生PE的独立危险因素(P<0.05);Pearson法分析结果显示,中晚期肺癌患者血清中IL-38 mRNA表达水平与miR-1233表达水平呈正相关(P<0.05);ROC分析结果显示,血清IL-38、miR-1233单独预估早期PE的最佳截断点分别为3.17、2.49,单独及联合预估的曲线下面积(AUC)分别为0.697、0.731、0.852。结论血清IL-38、miR-1233均对中晚期肺癌患者化疗后近期发生PE有较高预估价值,二者联合检测较单独检测预估价值更高。

Objective To investigate the predictive value of serum interleukin-38(IL-38)and microribonucleic acid-1233(miR-1233)levels in the risk of short-termpulmonary embolism(PE)in patients with advanced lung cancer after chemotherapy.Methods A total of 110 patients with advanced lung cancer who received chemotherapy in our hospital from May 2020 to May 2021 were selected as the research subjects.According to whether the patients developed PE within 3 months after chemotherapy,they were divided into PE group and non-PE group.The clinical data of the two groups of patients were collected,and the serum levels of IL-38 and miR-1233 and other influencing factors that could lead to early PE were compared between the two groups.Logistic regression analysis was used to analyze the risk factors of early PE in patients with advanced lung cancer after chemotherapy.The Pearson method was used to analyze the risk factors for early PE.The correlation between the expressions of IL-38 and miR-1233 in the serum of patients was analyzed;the receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum IL-38 and miR-1233 for the occurrence of early PE in patients with advanced PE after chemotherapy.Results The incidence of PE in 110 patients with advanced lung cancer within 3 months after chemotherapy was 51.82%(57/110).Univariate analysis showed that the levels of body mass index(BMI),adenocarcinoma percentage,D-dimerization(D-D),serum IL-38,and serum miR-1233 in the PE group were higher than those in the non-PE group(P<0.05).Logistic regression analysis showed that the high expression levels of D-D,serum IL-38,and miR-1233 were independent risk factors for the recent occurrence of PE in patients with advanced lung cancer after chemotherapy(P<0.05).The results of Pearson analysis showed that the expression level of IL-38 mRNA in the serum of patients with advanced lung cancer was positively correlated with the expression level of miR-1233(P<0.05).ROC analysis results showed that optimal cut-off points of serum IL-38 and miR-1233 for predicting early PE were 3.17 and 2.49,respectively,and the areas under the curve(AUC)for the individual and joint estimates were 0.697,0.731,and 0.852,respectively.Conclusion Both serum IL-38 and miR-1233 have higher predictive values for the recent occurrence of PE in patients with advanced lung cancer after chemotherapy,and the combined detection of the two has a higher predictive value than the single detection.