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乳酸脱氢酶和血清肿瘤标志物预测老年肺腺癌患者的转移状态。

Lactate dehydrogenase and serum tumor markers for predicting metastatic status in geriatric patients with lung adenocarcinoma.

机构信息

Shanxi Medical University, Taiyuan, Shanxi, China.

Shanxi Cancer Hospital, Affiliated Cancer Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.

出版信息

Cancer Biomark. 2019;26(2):139-150. doi: 10.3233/CBM-190201.

Abstract

BACKGROUND

No tumor biomarker (TM) is available for de novo metastatic lung adenocarcinoma.

OBJECTIVE

To examine the serum levels of carcinoembryonic antigen (CEA), cytokeratin-19 fragments (CYFRA21-1), neuron-specific enolase (NSE), carbohydrate antigen (CA) 19-9, CA125, tissue polypeptide antigen (TPA), tissue polypeptide specific antigen (TPS), and lactate dehydrogenase (LDH) to predict de novo metastatic lung adenocarcinoma.

METHODS

This was a retrospective study of geriatric (⩾ 60 years of age) patients with lung cancer diagnosed at Shanxi Cancer Hospital from 02/2012 to 12/2017. CEA, CYFRA21-1, CA199, NSE, CA125, TPA, and TPS were detected by ELISA and LDH was detected by LDH kit. Their predictive value was assessed using receiver operating characteristic (ROC) curves and multivariable logistic regression.

RESULTS

The positive rates of LDH and TMs were higher in the metastatic group (all P< 0.05). The best single TMs were CYFRA21-1 (70.5% sensitivity) and CA199 (92.0% specificity). When using any two, the best were CYFRA21-1+TPA (77.1% sensitivity) and CA199+TPA or NSE (both 84.1% specificity). High LDH and CA125 statuses were each independently associated with brain, bone, liver, and lung metastases (all P< 0.05).

CONCLUSIONS

Abnormal level of LDH and TMs, alone or in combination, had predictive value for metastasis in geriatric patients with lung adenocarcinoma; these indicators were also associated with the metastatic site.

摘要

背景

目前尚无用于新发转移性肺腺癌的肿瘤标志物(TM)。

目的

检测癌胚抗原(CEA)、细胞角蛋白 19 片段(CYFRA21-1)、神经元特异性烯醇化酶(NSE)、糖链抗原(CA)19-9、CA125、组织多肽抗原(TPA)、组织多肽特异性抗原(TPS)和乳酸脱氢酶(LDH)的血清水平,以预测新发转移性肺腺癌。

方法

这是一项回顾性研究,纳入了 2012 年 2 月至 2017 年 12 月在山西省肿瘤医院诊断为肺癌的老年(≥60 岁)患者。采用酶联免疫吸附试验(ELISA)检测 CEA、CYFRA21-1、CA199、NSE、CA125、TPA 和 TPS,采用乳酸脱氢酶试剂盒检测 LDH。采用受试者工作特征(ROC)曲线和多变量逻辑回归评估其预测价值。

结果

转移组的 LDH 和 TMs 阳性率均较高(均 P<0.05)。单一最佳 TMs 为 CYFRA21-1(敏感性 70.5%)和 CA199(特异性 92.0%)。使用两种 TMs 时,最佳组合为 CYFRA21-1+TPA(敏感性 77.1%)和 CA199+TPA 或 NSE(特异性均为 84.1%)。高 LDH 和 CA125 状态与脑、骨、肝和肺转移均独立相关(均 P<0.05)。

结论

LDH 和 TMs 单独或联合异常水平对老年肺腺癌患者的转移具有预测价值;这些指标也与转移部位有关。

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