分泌性磷蛋白1在肺癌所致恶性胸腔积液中的表达及其诊断价值

目的 探讨分泌性磷蛋白1(SPP1,别名osteopontin)在晚期肺癌所致恶性胸腔积液(MPE)中的表达及其作为辅助诊断的可能性.方法 选取96例肺癌患者MPE标本为病例组,遴选24例肺部良性疾病患者胸腔积液标本为对照组,使用ELISA法检测标本SPP1表达量.采用SPSS16.0软件统计,并用t检验分析病例组与对照组SPP1的表达水平,建立ROC曲线甄选cutoff界值.结果 在120例胸腔积液标本中,病例组SPP1含量(-x±s=1568.9±1297.15 ng/ml)较对照组(-x±s =644.12±480.50 n/ml)显著增高(t =4.766,P＜0.01),cutoff界值=1247.90 ng/ml(敏感度=38.54％,特异度=95.83％,曲线下面积0.662,95％,CI0.554～0.770).结论 SPP1在MPE中显著升高,胸腔积液中SPP1表达水平可用于MPE辅助诊断,但不适宜临床常规诊断.

SPP1 expressed in malignant pleural effusion in patients with advanced lung cancer and its value for diagnosis

Objective As a common complication of cancer, MPE significantly effect the respiratory function and survival of those patients. There is evidence accumulated that Secreted phosphoprotein-1 （SPP1 alias osteopontin） plays a key role in MPE caused by lung cancer, so our aim to find whether the expression of SPP1 in pleural effusion may be readily available diagnosis biomarker of MPE with advanced lung cancer patient. Methods A total of 96 patients with malignant pleural effusion were chose from our research center caused by lung cancer,while 24 control samples were collected fi＇om those benign lung diseases. ELISA were used to detect the contents of SPP1 from each specimen. SPSS16.0 statistical analysis software were used for the analysis, t test analysis was used to analysis SPP1 expression level both in case group and control group, then the ROC curve was used to select the cutoff value. Results In 120 specimens of pleural effusion, SPP1 expression level in case group is 1568.9 ± 1297.15 ng/ml（x ± s） while control group is 644.12 ±480.50 ng/ ml（^-x±s）. There is statistically significant difference between these two groups of SPP1 expression level （t = 4. 766, P 〈0.01 ）. With a cutoff value of 1247.90 ng/ml（ sensitivity38.54% ; specificity95.83% ; the area under the curve （AUC） 0.662 ; 95 % CI 0. 554-0. 770）. Conclusion SPP1 levels were elevated in malignant pleural effusions, as compared with the levels in benign pleural effusions. The SPP1 level in pleural effusion might be used as a diagnositic factor in advanced lung cancer patients but the diagnostic accuracy of the tests was not sufficient to permit routine use in clinical practice.