气管镜窄带成像联合血清HSP70、Ntn1对支气管肺癌的临床诊断价值

Clinical diagnostic value of bronchoscopic narrow band imaging combined with serum HSP70 and Ntn1 for bronchogenic carcinoma

目的探讨气管镜窄带成像联合血清热休克蛋白70(HSP70)、神经轴突导向因子1(Ntn1)对支气管肺癌的临床诊断价值。方法回顾性队列研究。回顾性分析2021年1月至2022年1月山西省肿瘤医院收治的96例疑似中央型肺癌合并气道阻塞患者的临床资料,所有患者均采用支气管光镜检查及窄带成像进行分析,采用酶联免疫吸附试验(ELISA)检测血清HSP70、Ntn1水平。以病理活组织检查结果为金标准,采用受试者工作特征(ROC)曲线分析气管镜窄带成像联合血清HSP70、Ntn1水平对支气管肺癌的诊断价值。结果96例疑似患者中,男性70例,女性26例,年龄(46±5)岁;经病理确诊中央型肺癌72例,其中鳞状细胞癌43例,腺癌24例,小细胞癌3例,未分化2例,肺部良性病变24例。气管镜窄带成像诊断支气管肺癌的灵敏度、特异度、准确度分别为90.3%、79.2%、87.5%。肺癌患者血清HSP70、Ntn1水平均高于良性患者(均P<0.05)。ROC曲线显示,HSP70、Ntn1诊断支气管肺癌的最佳临界值分别为10.08 ng/ml、562.82 pg/ml,血清指标(HSP70+Ntn1)诊断支气管肺癌的灵敏度、特异度、准确度分别为93.1%、58.3%、84.4%;气管镜窄带成像联合血清指标诊断支气管肺癌的灵敏度、特异度、准确度分别为98.6%、87.5%、95.8%,其准确度高于单独气管镜窄带成像或血清指标(χ^(2)值分别为4.36、7.07,均P<0.05)。结论气管镜窄带成像对支气管肺癌具有较好的诊断价值,而联合血清HSP70、Ntn1能进一步提高临床诊断效能。

Objective To investigate the clinical value of bronchoscopic narrow band imaging combined with serum heat shock protein family 70(HSP70)and netrin-1(Ntn1)in the diagnosis of bronchogenic carcinoma.Methods A retrospective cohort study was conducted.A total of 96 patients with suspected central lung cancer combined with airway obstruction admitted to Shanxi Province Cancer Hospital from January 2021 to January 2022 were retrospectively analyzed.Bronchoscopy and narrow band imaging were performed in all patients.Serum HSP70 and Ntn1 levels were measured by using enzyme-linked immunosorbent assay(ELISA).Pathological biopsy was taken as the gold standard.Receiver operating characteristic(ROC)curves were used to analyze the value of bronchoscopic narrow band imaging combined with serum HSP70 and Ntn1 in the diagnosis of bronchogenic carcinoma.Results There were 70 males and 26 females in 96 suspected patients,with the age of(46±5)years.According to the pathological results,72 were diagnosed with central lung cancer,including 43 cases of squamous cell carcinoma,24 cases of adenocarcinoma,3 cases of small cell carcinoma,2 undifferentiated cases,and 24 cases of benign lesions in lung.The sensitivity,specificity,and accuracy of bronchoscopic narrow band imaging in the diagnosis of bronchogenic carcinoma were 90.3%,79.2%and 87.5%,respectively.The serum HSP70 and Ntn1 levels in patients with lung cancer were higher than those in benign patients(all P<0.05).ROC curves showed that the optimal cut-off values of HSP70 and Ntn1 in the diagnosis of bronchogenic carcinoma were 10.08 ng/ml and 562.82 pg/ml,respectively.The sensitivity,specificity,and accuracy of serum markers(HSP70+Ntn1)in the detection of bronchogenic carcinoma were 93.1%,58.3%and 84.4%,respectively.The sensitivity,specificity,and accuracy of bronchoscopic narrow band imaging combined with serum markers in the diagnosis of bronchogenic carcinoma were 98.6%,87.5%and 95.8%,respectively;and the diagnostic accuracy of the combined method was higher than that of a single detection method such as bronchoscopic narrow band imaging or serum indexes(χ^(2) values were 4.36,7.07,all P<0.05).Conclusions Bronchoscopic narrow band imaging has a good diagnostic value for bronchogenic carcinoma,and the combination of serum HSP70 and Ntn1 can further improve the clinical diagnostic efficacy.