CAJ | 학술논문

巨噬细胞抑制因子-1及其联合多种标志物在肺癌早期诊断和诊断中的临床意义
거서세포억제인자-1급기연합다충표지물재폐암조기진단화진단중적림상의의
Clinical significance of macrophages inhibitory cytokine-1 and the combination with multiple biomarkers in the diagnosis and early diagnosis of lung cancer

万方数据

癌症进展癌癥進展 암증진전
ONCOLOGY PROGRESS
2015年 3期 306-311,316 ,共7页

张超%田海梅%李茉%王腾%李艳芬%刘静%杨塔娜%王小兵%赵文雅%沈迪%齐军%张伟

장초%전해매%리말%왕등%리염분%류정%양탑나%왕소병%조문아%침적%제군%장위

肺癌%巨噬细胞抑制因子-1%联合检测%早期诊断肺癌%巨噬細胞抑製因子-1%聯閤檢測%早期診斷
폐암%거서세포억제인자-1%연합검측%조기진단
lung cancer%macrophages inhibitory cytokine-1%combined detection%early diagnosis

目的：研究巨噬细胞抑制因子-1（macrophage inhibitory cytokine-1，MIC-1）在早期肺癌诊断中的辅助价值，并评价多种肿瘤标志物联合应用的临床意义。方法应用MIC-1定量检测试剂盒及Roche Cobas 601电化学发光免疫分析仪分别检测663例未经治疗的不同临床分期的肺癌患者和488例正常人群血清样本中的MIC-1、CEA、CA125、NSE、SCC和CYFRA21-1水平和分布，分析患者血清MIC-1水平与肺癌临床分期、病理分型和细胞分化程度的关系，并研究多种标志物联合检测的价值。结果肺癌患者血清MIC-1水平显著高于正常人群（P＜0.001）；MIC-1水平随临床分期的进展呈上升的趋势（P＜0.001），且与肿瘤浸润（P＜0.001）、淋巴结转移（P=0.02）、远端转移（P＜0.001）和肿瘤分化程度（P＜0.001）显著相关。单一检测MIC-1诊断肺癌的敏感度（76.6%）高于其他五种肺癌标志物的联合应用（72.2%），且MIC-1在鳞癌、腺癌、小细胞癌诊断中的敏感度均能达到甚至超过其他五种标志物的联合诊断水平（81.6%vs 82.8%；74.7%vs 68.9%；84.9%vs 83.0%）。在肺癌早期，以MIC-1为主的六种肿瘤标志物联合检测的诊断敏感度（Ⅰ期：79.8%；Ⅱ期：87.7%）显著高于其他五种肿瘤标志物联合诊断的敏感度（Ⅰ期：44.9%；Ⅱ期：72.6%）。结论 MIC-1是肺癌，尤其是早期肺癌有价值的血清肿瘤标志物，MIC-1和CEA、CA125、NSE、SCC、CYFRA21-1联合检测用于普通人群体检和肺癌早期诊断具有重要的临床意义和价值。
목적：연구거서세포억제인자-1（macrophage inhibitory cytokine-1，MIC-1）재조기폐암진단중적보조개치，병평개다충종류표지물연합응용적림상의의。방법응용MIC-1정량검측시제합급Roche Cobas 601전화학발광면역분석의분별검측663례미경치료적불동림상분기적폐암환자화488례정상인군혈청양본중적MIC-1、CEA、CA125、NSE、SCC화CYFRA21-1수평화분포，분석환자혈청MIC-1수평여폐암림상분기、병리분형화세포분화정도적관계，병연구다충표지물연합검측적개치。결과폐암환자혈청MIC-1수평현저고우정상인군（P＜0.001）；MIC-1수평수림상분기적진전정상승적추세（P＜0.001），차여종류침윤（P＜0.001）、림파결전이（P=0.02）、원단전이（P＜0.001）화종류분화정도（P＜0.001）현저상관。단일검측MIC-1진단폐암적민감도（76.6%）고우기타오충폐암표지물적연합응용（72.2%），차MIC-1재린암、선암、소세포암진단중적민감도균능체도심지초과기타오충표지물적연합진단수평（81.6%vs 82.8%；74.7%vs 68.9%；84.9%vs 83.0%）。재폐암조기，이MIC-1위주적륙충종류표지물연합검측적진단민감도（Ⅰ기：79.8%；Ⅱ기：87.7%）현저고우기타오충종류표지물연합진단적민감도（Ⅰ기：44.9%；Ⅱ기：72.6%）。결론 MIC-1시폐암，우기시조기폐암유개치적혈청종류표지물，MIC-1화CEA、CA125、NSE、SCC、CYFRA21-1연합검측용우보통인군체검화폐암조기진단구유중요적림상의의화개치。
Objective To investigate the accessory diagnostic value of macrophage inhibitory cytokine-1 (MIC-1) in patients with lung cancer, and estimate the clinical value of MIC-1 in combination with other biomarkers in the screening of early-stage lung cancer. Method The levels and distribution of MIC-1, CEA, CA125, NSE, SCC and Cyfra21-1 in serum samples from 663 previously untreated patients with different clinical stages of lung cancer and 488 healthy normal subjects were analyzed by self-produced MIC-1 double antibody sandwich ELISA Kit and Roche Cobas 601 ECL analyzer, respectively. The association of the serum levels of MIC-1 with clinical stages, pathologic types, and degrees of differentiation were analyzed. Additionally, the clinical value of MIC-1 and the combined bio-markers was explored. Result The serum levels of MIC-1 in patients with lung cancer were significantly higher than those in healthy control (P<0.001). A stepwise increase of MIC-1 levels was noted with the progress of lung cancer (P<0.001), and the levels were significantly correlated with the depth of tumor invasion (P<0.001), lymph node me-tastasis (P=0.02), remote metastasis (P<0.001) and degrees of differentiation (P<0.001). The sensitivity of MIC-1 was even superior to the parallel test of the other five biomarkers (76.6% vs 72.2%), specifically, displaying comparable or exceeding results in different pathological type of squamous carcinoma, adenocarcinoma and small-cell lung cancer (81.6% vs 82.8%; 74.7% vs 68.9%; 84.9% vs 83.0%). Furthermore, the sensitivities of MIC-1 combined with the oth-er five biomarkers in early-stage lung cancer were significantly increased from 44.9% to 79.8% in stage I and from 72.6% to 87.7% in stage II lung cancer. Conclusion MIC-1 is a valuable biomarker of lung cancer, especially in de-tection of early-stage lung cancer. The results imply that the parallel test of MIC-1 with CEA, CA125, NSE, SCC and Cyfra21-1 may have important clinical value in physical examination and in the diagnosis of early-stage lung can-cer.