微量元素与肺癌的关系及临床应用

为了探讨肺癌与微量元素之间的关系 ,采用PE30 30型原子吸收分光光度计对 30 0例肺癌、50例肺良性疾病患者及 10 0名健康成人的血清进行了铜、锌、铁、锰、钙水平及铜 /锌比值的测定。结果单因素分析表明 ,肺癌组、肺良性疾病组血清铜、锰的水平及铜 /锌比值均明显高于健康对照组 ,而锌和钙则明显低于健康对照组 ,差异显著 (分别P <0 .0 5～ 0 .0 1)。肺癌与肺良性疾病组之间比较 ,被测的元素及铜 /锌比值均无明显的变化 (P >0 .0 5)。 3组组内受检者职业、居住地、年龄段被测元素及铜 /锌比值比较无明显的变化 (P >0 .0 5)。结果还表明 ,60例化疗的肺癌患者缓解组血清铜水平及铜 /锌比值与治疗前比较明显下降 ,而锌、钙上升 ,未缓解组的铜 /锌比值与治疗前比较明显上升 ,差异有非常显著性(分别P <0 .0 1)。非条件logistic多因素分析表明 ,肺癌患者血清钙的比数比为 0 .9950 ,95%CI为0 .9910～ 0 .9990 ;铜 /锌比值的比数比为 7.9914,95%CI为 3.4 310～ 18.6134 ;提示血清钙可能是肺癌发病的一个保护因素 ;而铜 /锌比值可能是个危险因素。结果还提示 ,以健康对照组铜 /锌比值 1.10为界值 ,对肺癌诊断阳性率为 68% ;并对肺癌的疗效评价有一定参考价值。

Relationship of Serum Trace Elements to Lung Caner and Its Clinical Application

The levels of serum trace elements Cu,Zn,Fe,Mn and Ca were measured by PE3030 atomic absorption spectrophotometer in 300 patients with lung cancer,50 with nonmalignant pulmonary diseases and 100 healthy subjects. In addition, these trace elements were also measured in 60 cases with lung cancer (40 remitted, 20 non-remitted) before and after treatment. Results showed that the concentrations of serum Cu,Mn and Cu/Zn ratio were significantly higher ( P < 0.01) but Zn,Ca were significantly lower ( P <0.05- 0.01 ) in lung cancer and nonmalignant pulmonary diseases than in healthy controls. Within the three groups there has no difference among profession, area and age discovered. In the remitted patients with lung cancer, the levels of serum Cu and Cu/Zn ratio were significantly lower ( P <0.01) but Zn,Ca were significantly higher ( P <0.01 ) after treatment. In the non-remitted group,only Cu/Zn ratio was significantly higher ( P < 0.01) after treatment. Multivariable logistic regression analysis showed that the Odds Ratio (OR) of serum Ca was 0.9950 with 95% Confidence interval (CI) 0.9910-0.9990,and the OR of Cu/Zn was 7.9914 with 95% CI 3.4310-18.6134. It was suggested that Ca might play a protective vole while Cu/Zn ratio a risk factor for lung cancer. Results also showed that if the threshold of Cu/Zn ratio set at 1.10 in the healthy control group, the positive rate of Cu/Zn ratio was 68% which might be important in diagnosis and to assessing the prognosis of lung cancer.