血清补体C1q测定在恶性肿瘤诊断中的意义

Clinical significance of serum complement C1q in diagnosis of malignant tumors

目的探讨补体C1q在恶性肿瘤患者血清中的水平及其在恶性肿瘤诊断中的临床意义。方法血清补体C1q水平采用免疫比浊法进行定量检测,通过LIS系统统计2020年9月至2021年3月在我院初次确诊且未采取任何治疗措施的468例恶性肿瘤患者(其中肺恶性肿瘤患者164例、肝恶性肿瘤患者123例、胃恶性肿瘤患者108例、多发性骨髓瘤患者73例)的血清补体C1q水平进行回顾性分析,同时与健康对照组(50例体检健康者血清C1q水平)进行比较。结果肺恶性肿瘤组、肝恶性肿瘤组、胃恶性肿瘤组、多发性骨髓瘤组、健康对照组的血清C1q水平(mg/L)分别为(155.17±34.81)、(164.76±48.79)、(156.87±32.70)、(124.39±31.71)、(191.69±21.94),与对照组比较,四个恶性肿瘤组的血清C1q水平均显著低于对照组(P<0.05);四组恶性肿瘤患者血清C1q检测的灵敏度均在90%以上,多发性骨髓瘤的诊断效果较好(灵敏度91.7%,特异度86.3%);以正常组为对照,对多发性骨髓瘤、肺恶性肿瘤、肝恶性肿瘤、胃恶性肿瘤分别作ROC曲线分析,多发性骨髓瘤患者血清补体C1q水平的Cutoff值为157.8 mg/L,AUC面积为0.954;肺恶性肿瘤、肝恶性肿瘤、胃恶性肿瘤、全体肿瘤的补体C1q水平的Cutoff值分别为164.3、164.4、164.3、164.4mg/L,AUC面积分别为0.836、0.757、0.817、0.830。结论血清C1q水平测定对恶性肿瘤具有辅助诊断意义,尤其对多发性骨髓瘤的诊断效果较佳。

Objective To investigate the serum level of complement C1q in patients with malignant tumors and its clinical significance in the diagnosis of the tumors.Methods A retrospective analysis was conducted on 468 patients with malignant tumors(including 164 cases of lung malignant tumors,123 cases of liver malignant tumors,108 cases of gastric malignant tumors,and 73 cases of multiple myeloma)who were newly diagnosed and had not received any treatment measures from September 2020 to March 2021 in our hospital.Another 50 healthy individuals who taking physical examinations were subjected as control group.The serum level of complement C1q was quantitatively detected using the immunoturbidimetric assay.The levels were compared between the control and the patient groups.Results The serum C1q level was 155.17±34.81,164.76±48.79,156.87±32.70 and 124.39±31.71 mg/L,respectively in the lung,liver and gastric malignant tumor groups and multiple myeloma group,and the levels were significantly lower than that of the healthy control group(191.69±21.94 mg/L,P<0.05).The sensitivity of serum C1q detection in the 4 malignant tumor groups was all above 90%,and the diagnostic efficacy of multiple myeloma was better(sensitivity 91.7%,specificity 86.3%).Using the normal group as a control,ROC curve analysis indicated that the cut-off value of serum complement C1q level in multiple myeloma patients was 157.8 mg/L,with an AUC area of 0.954;and the value was 164.3,164.4,164.3 and 164.4 mg/L for c lung,liver and gastric malignant tumors and all these tumors,respectively,with an AUC value of 0.836,0.757,0.817 and 0.830,respectively.Conclusion Serum C1q level determination has auxiliary diagnostic significance for malignant tumors,especially for the diagnosis of multiple myeloma.