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壳多糖酶3样蛋白1在肺癌诊断中的临床价值
Clinical value of chitinase 3-like protein 1 in the diagnosis of lung cancer
【摘要】 目的 探讨壳多糖酶3样蛋白1(CHI3L1)在肺癌诊断中的临床价值。方法 选取2022年1-12月安徽医科大学第一附属医院北区收治的106例肺癌患者为肺癌组,同期收治的76例肺良性疾病患者作为肺良性疾病组及20例健康体检者作为对照组,采用酶联免疫吸附试验法检测CHI3L1水平,化学发光法检测癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段(CYFRA21-1)、鳞状细胞癌抗原(SCC-Ag)、胃泌素释放肽前体(ProGRP)水平。结果 肺癌组血清CEA、ProGRP、NSE、CYFRA21-1、CHI3L1水平较对照组明显升高,差异有统计学意义(P<0.05)。肺癌组血清CEA较肺良性疾病组明显升高,而血清CHI3L1较肺良性疾病组明显下降,差异有统计学意义(P<0.05)。与肺腺癌、肺鳞癌患者比较,小细胞肺癌患者血清NSE、ProGRP水平较高,差异有统计学意义(P<0.05);与肺腺癌、小细胞肺癌患者比较,肺鳞癌患者血清CYFRA21-1水平较高,差异有统计学意义(P<0.05)。与对照组比较,肺癌组Ⅰ~Ⅱ期患者血清NSE、CYFRA21-1、CHI3L1水平明显升高,差异有统计学意义(P<0.05)。对CEA、ProGRP、NSE、CYFRA21-1、CHI3L1进行多因素Logistic逐步回归分析,发现NSE、CHI3L1对肺癌的发生产生影响。CHI3L1、NSE联合检测诊断肺癌的灵敏度为96.2%,特异度为90.0%,曲线下面积为0.965。结论 血清CHI3L1可辅助肺癌的诊断与鉴别诊断,CHI3L1、NSE联合检测有助于临床对肺癌的早期发现,具有良好的临床应用价值。
【Abstract】 Objective To explore the clinical value of chitinase 3-like protein 1(CHI3L1) in the diagnosis of lung cancer.Methods A total of 106 patients with lung cancer admitted to the North District of the First Affiliated Hospital of Anhui Medical University from January to December 2022 were selected as the lung cancer group, 76 patients with benign lung disease admitted during the same period were selected as the benign lung disease group and 20 healthy subjects were selected as the control group.Enzyme-linked immunosorbent assay was used to detect CHI3L1 levels.The levels of carcinoembryonic antigen(CEA),neuron-specific enolase(NSE),cytokeratin-19 fragment(CYFRA21-1),squamous cell carcinoma antigen(SCC-Ag) and gastrin-releasing peptide precursor(ProGRP) were determined by chemiluminescence assay.Results The levels of CEA,ProGRP,NSE,CYFRA21-1 and CHI3L1 in lung cancer group were significantly higher than those in control group, and the differences were statistically significant(P<0.05).Serum CEA in lung cancer group was significantly higher than that in benign lung disease group, while serum CHI3L1 was significantly lower than that in benign lung disease group, with statistical significance(P<0.05).Serum levels of NSE and ProGRP were higher in patients with small cell lung cancer than those with lung adenocarcinoma and lung squamous cell carcinoma(P<0.05).Compared with patients with lung adenocarcinoma and small cell lung cancer, the serum CYFRA21-1 level in patients with lung squamous cell carcinoma was higher, and the difference was statistically significant(P<0.05).Compared with the control group, the serum levels of NSE,CYFRA21-1 and CHI3L1 in patients with stage Ⅰ to Ⅱ lung cancer group were significantly increased, and the difference was statistically significant(P<0.05).Multivariate Logistic stepwise regression analysis was performed for CEA,ProGRP,NSE,CYFRA21-1 and CHI3L1,and it was found that NSE and CHI3L1 had an effect on the occurrence of lung cancer.The sensitivity, specificity and area under the curve of CHI3L1 and NSE were 96.2%,90.0% and 0.965 respectively.Conclusion Serum CHI3L1 can assist in the diagnosis and differential diagnosis of lung cancer.The combined detection of CHI3L1 and NSE is helpful for the early detection of lung cancer and has good clinical application value.
【Key words】 lung cancer; chitinase 3-like protein 1; squamous cell carcinoma antigen; gastrin-releasing peptide precursor; neuron-specific enolase; cytokeratin-19 fragment;
- 【文献出处】 国际检验医学杂志 ,International Journal of Laboratory Medicine , 编辑部邮箱 ,2024年04期
- 【分类号】R734.2;R730.43
- 【下载频次】43