血清TRAP1、Cystatin-SN联合检测在肺结节鉴别诊断中的价值

Study on the diagnostic value of combined detection of serum TRAP1 and Cystatin-SN in benign and malignant pulmonary nodules

目的研究血清肿瘤坏死因子受体相关蛋白1(TRAP1)、半胱氨酸蛋白酶抑制剂SN(Cystatin-SN)联合检测在良性肺结节与恶性肺结节中的诊断价值。方法选取2021年7月—2023年6月江苏省扬州大学附属医院胸外科诊治的肺结节患者198例作为研究对象,根据病理检查结果分为良性结节组42例,恶性结节组156例。检测良性结节组和恶性结节组血清TRAP1、Cystatin-SN水平;绘制ROC曲线分析血清TRAP1、Cystatin-SN单一及联合检查对恶性肺结节的诊断效能。结果恶性结节组血清TRAP1、Cystatin-SN水平显著高于良性结节组,差异有统计学意义(t/P=32.273/<0.001、30.512/<0.001)。在恶性肺结节组中,有淋巴结转移、组织学低/未分化患者血清TRAP1、Cystatin-SN水平高于无淋巴结转移、组织学高/中分化患者,差异有统计学意义(t/P=11.812/<0.001、5.547/<0.001,16.837/<0.001、8.923/<0.001),而不同性别、临床症状、结节部位、病理类型患者比较,差异均无统计学意义(P>0.05)。ROC曲线分析结果表明,血清TRAP1、Cystatin-SN单独及二者联合检查诊断恶性肺结节的曲线下面积(AUC)分别为0.831、0.863和0.938,二者联合的AUC显著大于TRAP1、Cystatin-SN单独预测,差异有统计学意义(Z=2.127、2.038,P<0.05)。结论恶性肺结节患者血清中TRAP1、Cystatin-SN水平较高,二者联合检测在肺结节良恶性鉴别诊断中具有良好的应用价值。

Objective This study aims to investigate the diagnostic value of combined detection of serum tumor necrosis factor receptor associated protein 1(TRAP1)and cysteine protease inhibitor SN(Cystatin-SN)in benign and malignant pulmonary nodules,providing reference for clinical related diagnosis.Methods One hundred and ninety-eight patients with pulmonary nodules who visited between July 2021 and June 2023 were selected as the study subjects.According to pathological examination results,they were divided into a benign nodule group of 42 cases and a malignant nodule group of 156 cases.Compare the serum levels of TRAP1 and Cystatin-SN between the benign nodule group and the malignant nodule group;Compare the results of single and combined serum TRAP1 and Cystatin-SN tests;Compare the diagnostic efficacy of single or combined examinations for malignant pulmonary nodules;And observe the pathological characteristics of malignant pulmonary nodules,further analyze the correlation between serum TRAP1,Cystatin-SN levels and pathological features,and the results of multiple factor Poisson regression.Results The serum levels of TRAP1 and Cystatin-SN in the malignant nodule group were significantly higher than those in the benign nodule group,with statistical significance(t/P=32.273/<0.001、30.512/<0.001).In the group of malignant pulmonary nodules,there was a statistically significant difference in the levels of serum TRAP1 and Cystatin-SN in lymph node metastasis and histological differentiation(t/P=11.812/<0.001、5.547/<0.001,16.837/<0.001、8.923/<0.001);In the group of malignant pulmonary nodules,there was no statistically significant difference in the levels of serum TRAP1 and Cystatin-SN in terms of gender,clinical symptoms,nodule location,and pathological type(P>0.05).ROC curve analysis results showed that the area under the curve(AUC)of serum TRAP1 and Cystatin-SN alone and the combination of them were 0.831,0.863,0.938,respectively,and the AUC of the combination was significantly higher than that predicted by TRAP1 and Cystatin-SN alone,with statistical significance(Z=2.127、2.038,P<0.05)Conclusion Serum TRAP1 and Cystatin-SN have good clinical value in the differential diagnosis of benign and malignant pulmonary nodules,and it has been found that serum TRAP1 and Cystatin-SN levels are highly expressed in patients with malignant pulmonary nodules,which may become potential serum biomarkers.