摘要
目的:探讨I型胶原交联羧基末端肽(pyridinoline cross-linked C-telopeptides of type I collagen,I CTP)和骨唾液酸蛋白(bone s ialoprotein,BSP)在甲状腺癌骨转移早期诊断中的临床价值。方法:将确诊的甲状腺癌患者1 0 2例,分为无骨转移组和骨转移组,采用So l owa y分级将骨转移组病例分为4级(0~I I I级),ELI SA测定血清I CTP和BSP水平。半年后再次评估骨转移情况。结果:骨转移组血清I CTP和BSP水平明显高于无骨转移组及健康对照组(P<0.05)。骨转移组中随着转移病灶数目的增加,血清I CTP和BSP水平逐步升高,与病情进展呈显著正相关(P<0.01)。受试者工作特征曲线(receiver operating curve,ROC)分析显示:血清I CTP诊断甲状腺癌骨转移截断值为18 U/L,灵敏度85.2%,特异度98.9%,ROC曲线下面积0.967;血清BSP诊断甲状腺癌骨转移截断值为2.8 g/L,灵敏度87.9%,特异度99.1%,ROC曲线下面积0.976;初诊骨转移组和新发骨转移组的I CTP和BSP水平均显著高于无骨转移组(P<0.05)。结论:血清I CTP和BSP可用作诊断甲状腺癌骨转移的参考指标,通过对二者水平的监测可预测骨转移发生风险。
Objective： To study the clinical significance of serum pyridinoline cross-linked C-telopeptides of type I collagen（I CTP） and bone sialoprotein（BSP） to diagnose bone metastases in patients with thyroid cancer. Methods： A total of 102 patients with thyroid cancer were enrolled and allocated into 2 groups： Bone metastasis group and non-bone metastasis group. The bone metastasis group was assigned into 4 grades（0 to grade III） by soloway classification. The levels of serum I CTP and serum BSP were measured by ELISA. The bone metastasis was evaluated again by imaging examination after 6-month follow-up. Results： The levels of serum I CTP and BSP in patients with bone metastasis were significantly higher than those in the patients without bone metastasis and in 30 healthy control group（P〈0.05）. With the increase of the number of metastatic lesions in the bone metastasis group, the serum levels of I CTP and BSP were increased gradually, and they were positively correlated with the progression of the disease（P〈0.01）. According to the analysis of receiver operating curve（ROC）, the cut-off value, sensitivity and specificity in the diagnosis of tumor bone metastasis were 18 U/L, 85.2%, 98.9% for I CTP, and 2.8 g/L, 87.9%, 99.1% for BSP, respectively. Area under the curve（AUC） was 0.967 for I CTP, and 0.976 for BSP. Among the 52 patients without bone metastasis, 14 were found to have new metastasis during the follow-up. The levels of I CTP and BSP in patients with both new and old bone metastasis were significantly higher than those in the patients without bone metastasis（P〈0.05）. Conclusion： The serum I CTP and BSP are important biomarkers for diagnosis of bone metastasis, and the increase of their levels can be regarded as risk factors for bone metastasis.
作者
王军凯
李丽
WANG Junkai;LI Li(Department of Pathology,Xuchang Central Hospital,Xuchang Henan 461000;Department of Pathology,School of Basic Medical Sciences,Zhengzhou University,Zhengzhouj 450001,China)
出处
《临床与病理杂志》
2018年第7期1429-1433,共5页
Journal of Clinical and Pathological Research
基金
河南省教育厅科学研究重点项目(15A360016)~~
关键词
甲状腺癌
骨转移癌
I型胶原交联羧基末端肽
骨唾液酸蛋白
thyroid cancer
bone metastasis
pyridinoline cross-linked C-telopeptides of type I collagen
bone sialoprotein
