摘要
目的探讨血清血管生成素-2(Ang-2)、细胞外基质金属蛋白酶诱导因子(CD147)和胸苷激酶1(TK1)在孤立性肺结节(SPN)良恶性鉴别诊断中的临床价值。方法选择2019年1月至2021年6月在该院诊断为SPN的患者100例为研究对象,根据病理结果分为良性结节组(32例)和恶性结节组(68例)。比较良性结节组和恶性结节组血清Ang-2、CD147、TK1、细胞角质蛋白19片段抗原21-1(CYFRA21-1)和癌胚抗原(CEA)水平;分析血清Ang-2、CD147和TK1水平在预测SPN良恶性中的诊断效能;分析恶性SPN患者各临床指标间的关系。结果恶性结节组血清Ang-2、CD147、TK1、CYFRA21-1和CEA水平明显高于良性结节组(P<0.01)。血清Ang-2、CD147和TK1水平预测SNP恶性的效能明显优于CYFRA21-1和CEA(P<0.01),Ang-2、CD147、TK1联合检测的灵敏度为94.1%,特异度为97.1%,曲线下面积(AUC)为0.976,明显高于Ang-2(Z=2.890,P<0.01)、CD147(Z=3.635,P<0.01)和TK1(Z=3.959,P<0.01)单独检测,而这3个指标之间的AUC比较差异无统计学意义(P>0.05)。恶性SPN患者血清Ang-2、CD147和TK1水平与肿瘤最大径和淋巴结转移有关(P<0.01),而与性别、症状、吸烟情况、部位和组织学类型无关(P>0.05)。恶性SPN患者血清Ang-2水平与CD147水平(r=0.573,P<0.01)和TK1水平(r=0.683,P<0.01)呈正相关,血清CD147水平与TK1水平呈正相关(r=0.620,P<0.01)。结论血清Ang-2、CD147和TK1在SPN良恶性鉴别诊断中具有重要的临床价值,联合检测优于单个指标检测,值得进一步推广应用。
Objective To observe the clinical value of serum angiopoietin-2(Ang-2),extracellular matrix metalloproteinase inducible factor(CD147)and thymidine kinase 1(TK1)in the differential diagnosis of benign and malignant solitary pulmonary nodules(SPN).Methods A total of 100 patients diagnosed with SPN in this hospital from January 2019 to June 2021 were divided into benign nodules group(32 cases)and malignant nodules group(68 cases)according to the pathological results.The serum Ang-2,CD147,TK1,cyto-keratin 19 fragment antigen 21-1(CYFRA21-1)and carcinoembryonic antigen(CEA)levels were compared between the benign nodules group and malignant nodules group.The serum levels of Ang-2,CD147 and TK1 in predicting the diagnostic efficacy of malignant SPN were observed,the relationship between those and the clinical indexes of patients with malignant SPN,and the relationship among them were also observed.Results The levels of serum Ang-2,CD147,TK1,CYFRA21-1 and CEA in patients with SPN in the malignant nodules group were significantly higher than those in the benign nodules group(P<0.01).The diagnostic efficacy of serum Ang-2,CD147 and TK1 levels in patients with SPN in predicting malignancy were significantly better than CYFRA21-1 and CEA(P<0.01).The combined detection(Ang-2+CD147+TK1)had a sensitivity of 94.1%,specificity of 97.1%,and the area under curve(AUC)of 0.976 was significantly higher than that of Ang-2(Z=2.890,P<0.01),CD147(Z=3.635,P<0.01)and TK1(Z=3.959,P<0.01).There were no statistically significant difference in AUC among these indicators(P>0.05).The serum Ang-2,CD147 and TK1 levels of SPN malignant patients were significantly correlated with tumor diameter and lymph node metastasis(P<0.01),but not significantly correlated with gender,symptoms,smoking,location and histological type(P>0.05).The serum Ang-2 levels in patients with malignant SPN were positively correlated with CD147(r=0.573,P<0.01)and TK1(r=0.683,P<0.01),and the serum CD147 level was positively correlated with TK1(r=0.620,P<0.01).Conclusion The serum Ang-2,CD147 and TK1 levels have important clinical value in the differential diagnosis of SPN benign and malignant.The combined detection is better than single index detection,it is worthy of further promotion and application.
作者
乔弟
王强
曾颖鸥
戴斌
邬云龙
王勐
QIAO Di;WANG Qiang;ZENG Ying′ou;DAI Bin;WU Yunlong;WANG Meng(Department of Thoracic Surgery,Zhoupu Hospital Affiliated to Shanghai Health Medical College,Shanghai 201318,China)
出处
《检验医学与临床》
CAS
2022年第19期2667-2671,共5页
Laboratory Medicine and Clinic
关键词
血管生成素-2
细胞外基质金属蛋白酶诱导因子
胸苷激酶1
孤立性肺结节
鉴别诊断
angiopoietin-2
extracellular matrix metalloproteinase inducible factor
thymidine kinase 1
solitary pulmonary nodule
differential diagnosis
