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目的探讨肺癌患者血清骨桥蛋白(osteopontin,OPN)与解整合素-金属蛋白酶8(disintegrin and metalloprotease8,ADAM8)水平变化及临床意义。方法小细胞肺癌(small cell lung cancer,SCLC)患者24例(SCLC组),非小细胞肺癌(non-small cell lung cancer,NSCLC)患者60例(NSCLC组),同期体检健康者20例(对照组),采用ELISA法检测3组血清OPN及ADAM8水平,分析血清OPN、ADAM8与NSCLC临床病理特征的关系;绘制ROC曲线分析血清OPN、ADAM8诊断SCLC和NSCLC的效能。结果血清OPN和ADAM8水平在NSCLC组[(36.86±11.00)μg/L、(2 695.99±568.86)ng/L]、SCLC组[(35.47±12.01)μg/L、(2 428.82±415.42)ng/L]均高于对照组[(25.45±10.71)μg/L、(1 737.29±594.36)ng/L](P<0.05),NSCLC组与SCLC组比较差异无统计学意义(P>0.05);NSCLC组血清OPN与ADAM8水平呈正相关(r=0.440,P=0.001),SCLC组、对照组血清OPN与ADAM8水平无线性相关(r=0.180,P=0.468;r=0.110,P=0.725);NSCLC组病理分期Ⅲ+Ⅳ期、有淋巴结转移、有远处转移者血清OPN和ADAM8水平高于Ⅰ+Ⅱ期、无淋巴结转移、无远处转移者(P<0.05);血清OPN为26.73μg/L时,诊断NSCLC的AUC为0.779(95%CI:0.618~0.940,P=0.002),灵敏度为86.7%,特异度为66.7%;血清ADAM8为1 673.76ng/L时,诊断NSCLC的AUC为0.869(95%CI:0.752~0.987,P<0.001),灵敏度为100.0%,特异度为66.7%;血清OPN为24.50μg/L时,诊断SCLC的AUC为0.745(95%CI:0.559~0.932,P=0.025),灵敏度为88.9%,特异度为58.3%;血清ADAM8为1 783.50ng/L时,诊断SCLC的AUC为0.806(95%CI:0.627~0.984,P=0.005),灵敏度为94.4%,特异度为66.7%。结论血清OPN及ADAM8对NSCLC和SCLC的诊断有一定价值;血清OPN、ADAM8水平与NSCLC患者临床病理特征有关,可作为NSCLC病情监测和预后评估的指标。
Objective To investigate the changes of serum osteopontin (OPN) and the levels of disintegrin and metalloprotease 8 (ADAM8) in patients with lung cancer and their clinical significance. Methods Twenty-four patients (SCLC group), 60 patients (NSCLC group) with non-small cell lung cancer (NSCLC) and 20 healthy people (control group) Group). The levels of OPN and ADAM8 were detected by ELISA. The relationship between serum OPN, ADAM8 and clinicopathological features of NSCLC was analyzed. ROC curve was used to analyze the effect of serum OPN and ADAM8 in diagnosis of SCLC and NSCLC. Results Serum levels of OPN and ADAM8 were significantly higher in NSCLC patients (36.86 ± 11.00 μg / L, 2695.99 ± 568.86 ng / L), SCLC patients (35.47 ± 12.01) μg / L and (4282.84 ± 415.42) ng / (P <0.05). There was no significant difference between NSCLC group and SCLC group (P> 0.05). There was no significant difference between NSCLC group and SCLC group (P> 0.05). Serum levels of OPN and ADAM8 in NSCLC group were positively correlated (r = 0.440, P = 0.001). Serum levels of OPN and ADAM8 in SCLC group and control group were not correlated with ADAM8 level (r = 0.180, P = 0.468; r = 0.110, P = 0.725) The levels of serum OPN and ADAM8 in patients with NSCLC were higher than those in patients with stage Ⅰ + Ⅱ, no lymph node metastasis and distant metastasis (P <0.05). Serum OPN was 26.73μg / L, the AUC of diagnosing NSCLC was 0.779 (95% CI: 0.618-0.940, P = 0.002), with a sensitivity of 86.7% and a specificity of 66.7%. When serum ADAM8 was 1 673.76 ng / L, the AUC of diagnosis of NSCLC was (95% CI: 0.752-0.987, P <0.001). The sensitivity and specificity were 100.0% and 66.7%, respectively. The serum AUC of OPLC was 24.50μg / L and the AUC was 0.745 (95% CI: 0.559-0.932, P = 0.025), with a sensitivity of 88.9% and a specificity of 58.3%. AUC of diagnosing SCLC of 1.783.50 ng / L for serum ADAM8 was 0.806 (95% CI: 0.62 7 to 0.984, P = 0.005), with a sensitivity of 94.4% and a specificity of 66.7%. Conclusions Serum OPN and ADAM8 are valuable for the diagnosis of NSCLC and SCLC. Serum levels of OPN and ADAM8 are correlated with the clinicopathological features of patients with NSCLC and may be used as indicators for the monitoring and prognosis evaluation of NSCLC.