發(fā)布時間：2018-04-26 21:24

  本文選題：肺腫瘤 + 生長分化因子��； 參考：《中國全科醫(yī)學(xué)》2017年15期

【摘要】：目的探討血清生長分化因子15(GDF-15)水平在肺癌的診斷及化療療效評估中的價(jià)值,為臨床提供參考。方法選取2015年12月—2016年8月就診于安徽醫(yī)科大學(xué)第一附屬醫(yī)院呼吸內(nèi)科符合納入標(biāo)準(zhǔn)的肺癌患者88例、肺炎患者31例以及來自本院體檢中心的健康者41例,分別作為肺癌組、肺炎組和正常對照組。檢測患者入院時、健康者體檢第1天時血清GDF-15水平,同時收集肺癌組患者吸煙情況、合并糖尿病情況、實(shí)驗(yàn)室檢查指標(biāo)[血紅蛋白(HGB)、前清蛋白(PA)、乳酸脫氫酶(LDH)]、病理學(xué)特征(T分期、N分期、臨床分期、病理類型);收集肺炎組、肺癌組患者血清GDF-15、癌胚抗原(CEA)、神經(jīng)元特異性烯醇化酶(NSE)、細(xì)胞角蛋白19片段(CYFRA21-1)水平,繪制其診斷肺癌的受試者工作特征(ROC)曲線。觀察連續(xù)2個化療周期后肺癌組患者的臨床療效,并檢測其血清GDF-15水平,分析血清GDF-15水平評估不同化療療效的價(jià)值。結(jié)果肺炎組、肺癌組血清GDF-15水平高于正常對照組(P0.05);肺癌組血清GDF-15水平高于肺炎組(P0.05)。體質(zhì)指數(shù)≥24 kg/m~2肺癌組患者血清GDF-15水平高于體質(zhì)指數(shù)24 kg/m~2者,合并糖尿病肺癌組患者血清GDF-15水平高于無糖尿病者,血清HGB水平低于正常的肺癌組患者血清GDF-15水平高于血清HGB水平正常者(P0.05)。T_(1~2)期肺癌組患者血清GDF-15水平低于T_(3~4)期者(P0.05)。血清GDF-15水平診斷肺癌的截?cái)嘀禐? 199.05 ng/L,其靈敏度為78.2%,特異度為71.0%,ROC曲線下面積(AUC)為0.851[95%CI(0.774,0.910)],約登指數(shù)為0.492。血清CEA、NSE、CYFRA21-1水平診斷肺癌的AUC分別為0.630[95%CI(0.537,0.717)]、0.720[95%CI(0.631,0.799)]和0.654[95%CI(0.561,0.739)]。血清GDF-15水平診斷肺癌的AUC大于血清CEA、NSE、CYFRA21-1水平診斷肺癌的AUC(P0.05)。肺癌組64例患者完成連續(xù)2個化療周期,其中部分緩解11例、疾病穩(wěn)定33例、疾病進(jìn)展20例�；熀蟛煌熜Х伟┙M患者血清GDF-15、CEA水平比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);化療后不同療效肺癌組患者血清NSE、CYFRA21-1水平比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論血清GDF-15水平可作為篩查肺癌的血清標(biāo)志物,且有望成為化療療效評價(jià)的新指標(biāo)。
[Abstract]:Objective to investigate the value of serum GDF-15 level in the diagnosis of lung cancer and the evaluation of chemotherapeutic efficacy. Methods from December 2015 to August 2016, 88 patients with lung cancer, 31 patients with pneumonia and 41 healthy people from the physical examination center of Anhui Medical University were selected as lung cancer group. Pneumonia group and normal control group. At the first day of physical examination, the serum GDF-15 level was measured, and the smoking status and diabetes mellitus were collected in lung cancer group. Laboratory examination index [HGB, PAP, LDH], pathological features, T staging, clinical stage, pathological type; collecting pneumonia group, collecting pneumonia group, collecting pneumonia group, collecting pneumonia group, collecting pneumonia group, collecting pneumonia group, collecting pneumonia group, collecting pneumonia group, collecting pneumonia group, collecting pneumonia group, collecting pneumonia group, collecting pneumonia group, Serum levels of GDF-15, carcinoembryonic antigen (CEA), neuron-specific enolase (NSEE) and cytokeratin 19 fragment (CYFRA21-1) in patients with lung cancer were determined. To observe the clinical curative effect of lung cancer patients after two consecutive chemotherapy cycles, to detect the serum GDF-15 level and to analyze the value of serum GDF-15 level in evaluating the different chemotherapeutic effects. Results the serum GDF-15 level in lung cancer group was higher than that in normal control group (P 0.05), and the serum GDF-15 level in lung cancer group was higher than that in pneumonia group (P 0.05). The serum GDF-15 level in patients with BMI 鈮，

本文編號：1807754