HE4、CEA和leptin表达对肺癌的诊断价值及其与病理分期、分化程度的关系

The expression levels of HE4,CEA and leptin in the diagnosis value of lung cancer and their relationship with pathological staging and differentiation degree

目的分析人附睾蛋白4(Human epididymis protein 4,HE4)、癌胚抗原(Carcinoembryonic antigen,CEA)和瘦素(leptin)表达水平对肺癌患者的诊断价值及其与患者病理分期、分化程度的关系。方法本研究纳入2022年1月~2023年12月在本院就诊的肺癌患者为研究组,共计120例,选取同期在本院体检的健康体检者为对照组以及经检查后为肺部良性疾病者为肺部良性疾病组,各60例。对比三组患者血清中HE4、CEA和leptin水平;对比不同分期以及不同细胞分化程度患者血清中HE4、CEA和leptin水平;分析血清中HE4、CEA和leptin水平与肺癌分期以及分化程度的相关性;采用受试者工作特征(Receiver operating characteristic,ROC)曲线分析血清中HE4、CEA、leptin单独或联合检测对肺癌的诊断价值。结果肺癌患者血清中HE4、leptin及CEA水平均显著高于肺部良性组和对照组(P<0.05);Ⅰ~Ⅱ期组患者血清中HE4、leptin及CEA水平均显著低于Ⅲ~Ⅳ期组(P<0.05);高分化组血清中HE4、leptin及CEA水平均显著高于中分化组以及低分化组(P<0.05);Spearman相关性分析表明血清中HE4、leptin和CEA水平与肺癌分期以及分化程度呈显著正相关(P<0.05);ROC曲线表明,HE4、CEA、leptin单独及联合检测诊断肺癌的曲线下面积分别为0.870、0.849、0.879以及0.958。结论肺癌患者的血清HE4、CEA和leptin水平均显著升高,且与肺癌的临床分期和细胞分化程度有一定的相关性,联合检测HE4、CEA和leptin指标对肺癌的诊断具有较高的价值,可以作为肺癌的筛查和早期诊断工具。

Objective To analyze the expression levels of human epididymis protein 4(HE4),carcinoembryonic antigen(CEA)and leptin in the diagnosis of lung cancer patients and their relationship with pathological staging and differentiation.Methods 120 lung cancer patients who visited our hospital from Jan 2022 to Dec 2023 as the study group.60 healthy individuals who underwent physical examinations at the same time in our hospital's physical examination center were selected as the control group,and 60 patients with benign lung diseases were selected as the benign lung disease group after examination.Compared the serum levels of HE4,CEA and leptin in the three groups of patients,and compared the serum levels of HE4,CEA and leptin in patients with different stages and degrees of cell differentiation.Analyzed the correlation between the serum levels of HE4,CEA and leptin and the stages and degrees of lung cancer.Analyzed the diagnostic value of HE4,CEA and leptin in the serum alone or in combination for lung cancer by receiver operating characteristic curve(ROC).Results The serum levels of HE4,leptin and CEA in lung cancer patients were significantly higher than those in the benign lung disease group and the control group(P<0.05).The serum levels of HE4,leptin and CEA in stageⅠ~Ⅱgroup were significantly lower than those in stageⅢ~Ⅳgroup(P<0.05).The serum levels of HE4,leptin and CEA in the highly differentiated group were significantly higher than those in the medium-differentiated and the low-differentiated group(P<0.05).Spearman correlation analysis showed that the levels of serum HE4,leptin and CEA were significantly positively correlated with the stage and differentiation of lung cancer(P<0.05).The ROC curve results showed that the area under the curve for the diagnosis of lung cancer by detecting HE4,CEA and leptin alone and in combination were 0.870,0.8490.879 and 0.958,respectively.Conclusion The serum levels of HE4,CEA and leptin in lung cancer patients are significantly elevated which correlated with the clinical stage and cell differentiation degree of lung cancer.Combined detection of HE4,CEA and leptin indicators has high diagnostic value for lung cancer,which can be used as a tool for screening and early diagnosis of lung cancer.