【摘要】 目的探讨血清碱性磷酸酶(alkaline phosphatase,ALP)、Ⅰ型胶原氨基末端肽(N-terminal telopeptide of typeⅠcollagen,NTX)及肿瘤标志物水平与肺癌骨转移的关系。方法选取2016年7月至2018年7月上海市皮肤病医院和上海市第十人民医院初诊的74例原发性肺癌患者为研究对象。根据患者是否发生骨转移将其分为骨转移组(37例)和无骨转移组(37例)。观察两组患者血清ALP、NTX、癌胚抗原(carcinoembryonic antigen,CEA)、糖类抗原(carbohydrate antigen,CA)153、CA125、CA199、CA724水平,采用单因素和多因素分析探讨肺癌患者发生骨转移的危险因素。结果骨转移组患者血清ALP、NTX水平均显著高于无骨转移组(均P<0.05)。血清ALP诊断肺癌骨转移的灵敏度和特异度分别为63.6%和75.3%,血清NTX诊断肺癌骨转移的灵敏度和特异度分别为69.7%和64.2%。血清ALP、NTX、CEA、CA153和CA125均与肺癌患者骨转移相关(均P<0.05),多因素分析显示CEA和CA125是肺癌患者骨转移的独立危险因素(均P<0.05)。结论血清ALP、NTX水平在肺癌患者骨转移诊断方面有一定临床应用价值,肿瘤标志物CEA、CA125水平升高亦有协助诊断价值。更多还原

【Abstract】 Objective To investigate the relationship between serum alkaline phosphatase(ALP),N-terminal telopeptide of type I collagen(NTX) and tumor markers and bone metastases in lung cancer.Method 74 patients with primary lung cancer newly diagnosed in Shanghai Skin Disease Hospital and Shanghai Tenth People’s Hospital from July 2016 to July 2018 were selected as the research subjects.Patients were divided into bone metastasis group(37 cases) and non-bone metastasis group(37 cases) according to whether or not bone metastasis occurred.The serum ALP,NTX,carcinoembryonic antigen(CEA),carbohydrate antigen(CA) 153,CA125,CA199,CA724 level were observed,and use univariate and multivariate analysis to explore risk factors for bone metastases in lung cancer patients.Result Serum ALP and NTX levels in patients with bone metastasis group were significantly higher than those in patients with non-bone metastasis group(all P <0.05).The sensitivity and specificity of serum ALP in the diagnosis of bone metastases from lung cancer were 63.6% and 75.3%,respectively,and sensitivity and specificity of serum NTX in the diagnosis of bone metastases from lung cancer were 69.7% and 64.2%,respectively.Serum ALP,NTX,CEA,CA153 and CA125 were all related to bone metastases in lung cancer patients(all P <0.05).Multivariate analysis showed that elevated CEA and CA125 were independent risk factors for bone metastases in lung cancer patients(all P <0.05).Conclusion The serum levels of ALP and NTX have clinical application value in the diagnosis of lung cancer patients with bone metastases,and CEA,CA125 has some supplementary diagnostic value.更多还原