摘要
目的探讨肺癌患者血清肿瘤坏死因子-α(TNF-α)检测的临床意义。方法选择2017年3月—2018年12月重庆医科大学附属第一医院收治的60例肺癌患者作为肺癌组,13例肺部良性疾病患者作为肺病组,另外选择同期39名健康体检者作为对照组。使用化学发光分析仪检测所有受检者血清TNF-α,使用全自动电化学发光分析仪检测常见肺癌肿瘤标志物〔包括癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、细胞角质蛋白19片段(CYFRA21-1)〕。比较各组血清TNF-α水平,分析TNF-α在不同临床病理特征肺癌患者中的差异。绘制受试者工作特征曲线(ROC曲线)并计算ROC曲线下面积(AUC),分析上述肿瘤标志物对肺癌的诊断效能。结果肺癌组血清TNF-α水平明显高于肺病组和对照组(ng/L:14.10±9.71比7.87±2.85、6.35±1.80,均P<0.05)。肿瘤直径>3 cm肺癌患者的血清TNF-α水平明显高于直径≤3 cm的肺癌患者(ng/L:15.05±10.53比8.87±2.03,P<0.05);发生淋巴结转移肺癌患者的血清TNF-α水平明显高于未发生淋巴结转移的肺癌患者(ng/L:15.53±10.56比9.59±3.57,P<0.05);肺癌患者血清TNF-α水平与肺部肿瘤的组织病理学类型、病理分期以及患者的性别、年龄、是否吸烟等均无显著相关性。ROC曲线显示,当取截断值为8.665 ng/L时,血清TNF-α对肺癌诊断的AUC为0.872,95%可信区间(95%CI)为0.792~0.953,敏感度为75.0%,特异度为94.1%,血清TNF-α与CEA、NSE、CYFRA21-1联合检测的AUC为0.976(95%CI为0.943~0.999),敏感度为92.5%,特异性度为97.1%。结论血清TNF-α与肺癌肿瘤大小、淋巴结转移状态高度相关,值得进一步扩大样本量进行研究。
Objective To investigate the clinical significance of serum tumor necrosis factor-α(TNF-α)detection in lung cancer patients.Methods From March 2017 to December 2018,60 lung cancer patients admitted to the First Affiliated Hospital of Chongqing Medical University were selected as lung cancer group,13 patients with benign lung diseases and 39 healthy controls were as lung disease group and control group.The levels of TNF-α and tumor markers[carcinoembryonic antigen(CEA),neuron specific enolase(NSE)and cytokeratin 19 fragment(CYFRA21-1)]were detected by chemiluminescent analyzer and electrochemiluminescence analyzer.The TNF-α levels in different groups were compared,and the TNF-α levels in patients with different pathological characteristics were analyzed.The receiver operator characteristic(ROC)curvewas drawn and the area under ROC curve(AUC)was calculated to analyze the diagnostic efficacy of different biomarkers for lung cancer.Results The TNF-α level in lung cancer group was higher than those in lung disease group and control group(ng/L:14.10±9.71 vs.7.87±2.85,6.35±1.80,both P<0.05).The TNF-α level in lung cancer patients with tumor diameter>3 cm was higher than that of patients with diameter≤3 cm(ng/L:15.05±10.53 vs.8.87±2.03,P<0.05).The TNF-αlevel in patients with lymph node metastasis was higher than that in patients without lymph node metastasis(ng/L:15.53±10.56 vs.9.59±3.57,P<0.05).The TNF-α level in patients with lung cancer was not correlated with the histopathological type and pathological stage of lung tumors,as well as the smoking status,gender and age of patients.ROC curve showed that when the cut-off value was 8.665 ng/L,the AUC of TNF-α for lung cancer diagnosis was 0.872,95%confidence interval(95%CI)was 0.792-0.953,sensitivity was 75.0%,and specificity was 94.1%.The AUC of combined detection of TNF-α,CEA,NSE and CYFRA21-1 was 0.976,95%CI was 0.943-0.999,sensitivity was 92.5%,and specificity was 97.1%.Conclusions TNF-α has a high correlation with the tumor size and lymph node me
作者
李德涛
张玉婷
侯玉磊
Li Detao;Zhang Yuting;Hou Yulei(Department of Clinical Laboratory,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)
出处
《实用检验医师杂志》
2022年第2期182-185,共4页
Chinese Journal of Clinical Pathologist
关键词
肿瘤坏死因子-Α
肺癌
肿瘤大小
淋巴结转移
Tumor necrosis factor-α
Lung cancer
Tumor size
Lymph node metastasis
