血清碱性磷酸酶和血清钙水平测定对原发性肺癌骨转移的临床诊断价值

目的:探讨血清碱性磷酸酶(alkaline phosphatase,ALP)、血清钙水平测定对原发性肺癌骨转移的临床诊断价值.方法:收集确诊为原发性肺癌患者342例,其中发生骨转移者120例,无骨转移者222例,于入院第2天清晨空腹抽取静脉血2 mL,采用全自动生化分析仪对所有患者进行血清ALP、血清钙检测,并计算校正血钙水平.结果:不同病理类型肺癌骨转移发生率差异有统计学意义(P<0.05).肺癌骨转移组血清ALP、校正血钙水平均明显高于无骨转移组(P<0.01).多发骨转移组(骨转移数≥2)ALP水平均明显高于单发骨转移组及无骨转移组(P<0.01);多发与单发骨转移组校正血钙水平均明显高于无骨转移组(P<0.01),但多发骨转移组与单发骨转移组校正血钙水平差异无统计学意义(P>0.05).血清ALP与校正血钙在肺癌骨转移诊断中的灵敏度分别为40.8%、60.0%,特异度分别为79.7%、75.2%,联合检测血清ALP及校正血钙水平时灵敏度及特异度均较高,分别为78.3%、61.7%.结论:不同病理类型肺癌患者骨转移发生率不同;单独或联合检测血清ALP及校正血钙对诊断肺癌骨转移有较高的灵敏度及特异度,有一定的辅助诊断价值.

Clinical value of the levels of serum alkaline phosphatase and calcium in diagnosing the bone metastasis of primary lung cancer

Objective:To investigate the clinical value of the levels of serum alkaline phosphatase( ALP) and calcium in diagnosing the bone metastasis of primary lung cancer. Methods:Among 342 patients with primary lung cancer,120 cases with bone metastasis and 222 cases without bone metastasis were identified. The levels of serum ALP and calcium in all patients were detected using automatic biochemical analyzer,and the corrected serum calcium level was calculated. Results:The difference of the incidence of bone metastases in different pathological type lung cancer was statistically significant(P<0. 05). The levels of serum ALP and corrected calcium in lung cancer patients with bone metastasis were significantly higher than those in the patients without bone metastasis(P<0. 01). The level of serum ALP in patients with multiple bone metastasis ( lesions≥2 ) was obviously higher than that in the patients with single bone metastasis and without bone metastasis(P<0. 01). The level of corrected calcium in patients with multiple and single bone metastasis was significantly higher than that in patients without bone metastasis(P<0. 01),but the difference of which between the multiple and single bone metastasis patients was not statistically significant(P>0. 05). The sensitivity and specificity of serum ALP and corrected calcium in the diagnosis of lung cancer patients with bone metastasis were 40. 8% & 60% and 79. 7% & 75. 2%,respectively. The sensitivity and specificity of the combined detection of serum ALP and correction calcium were 78. 3% and 61. 7%, respectively. Conclusions:The incidence of bone metastasis in different pathological types lung cancer is different. The combined or single detection of serum ALP and corrected calcium have higher sensitivity and specificity in diagnosing the bone metastasis of lung cancer,and which has certain clinical application value.