血清唾液酸水平检测在非小细胞肺癌中的诊断价值

目的 评估血清唾液酸水平在非小细胞肺癌诊断与疗效监测中的应用价值.方法 采用酶法对60例健康人(健康对照组),30例肺部良性疾病患者(肺部良性疾病组),100例非小细胞肺癌患者(非小细胞肺癌组)进行血清唾液酸含量的统计分析.结果 健康对照组血清唾液酸水平为(568±62) mg/L,肺部良性疾病组和非小细胞肺癌组血清唾液酸水平分别为(639±92) mg/L和(813±218)mg/L,非小细胞肺癌患者血清的唾液酸水平明显高于健康对照组和良性疾病组(P＜0.01)；根据健康对照组的检测数值,唾液酸检测非小细胞肺癌的Cut-off值为695 mg/L,敏感度为69.00％,特异度为88.90％.100例非小细胞肺癌患者中,腺癌、鳞癌、鳞腺癌和未分化癌各25例.其中腺癌组、鳞癌组、鳞腺癌组和未分化癌组血清唾液酸水平分别为( 845±91) mg/L、(782±91)mg/L、(794±126)mg/L和(831±113) mg/L,不同组织病理类型的恶性肿瘤的血清唾液酸含量明显高于对照组,但各组织病理类型的恶性肿瘤之间的血清唾液酸含量差异无统计学意义(P＞0.05).非小细胞肺癌患者血清唾液酸水平随着肿瘤分级、分期的升高而升高.结论 血清中唾液酸检测在非小细胞肺癌的筛查、诊断、术后疗效评估及监测均有重要意义.

Estimation of serum total sialic acid levels as tumor markers in non-small cell lung cancer

Objective Sialic acid has recently been suggested as a marker of non-small cell lung cancer. The purpose of this study was to evaluate the utility of serum sialie acid in diagnosis and early detection of non-small cell lung cancer. Methods We analyzed serum samples that had been collected between 2010 and 2011 from 100 patients with Non-small cell lung cancer of different histopathology types before tumor resection at various stages stage Ⅰ （n =15）, stage Ⅱ （n =25）, stage Ⅲ （n =40）, and stagelV（n =20） ] ; adenocarcinoma（n =25）, squamous cell carcinoma （ n = 25 ）, adenosquamous carcinoma （ n = 25）, undifferentiated carcinoma （ n = 25）, 30 benign lung disease patients asthma （n = 11 ）, pneumonia（ n = 19） ] and 60 age-matched healthy persons with no evidence of lung disease and/or of neoplasm. All patients and controls gave their informed consent to enrollment in the present study, which was ethically conducted in accordance with the Helsinki Declaration. The enzymatic was em- ployed to detect the content of serum sialic acids. We compared results between the patients with and without cancer and between different histopathology types. The statistical analysis of the data was done using SPSS version 17.0 software. The diagnostic performance of an assay was assessed by the analysis of receiver-operating characteristic （ROC） curves. The tumor marker levels between the benign and lung cancer patient groups were compared using the Student＇s t-test. Frequencies and percentages were calculated, and the X2 was used for categorical factors. Results Serum sialic acid in malignant patients, benign cases and healthy subjects were （813 ±218）mg/L, （639 ± 92） mg/L and （568 ±62） mg/L. The levels of serum sialic acid were significantly increased in malignant compared to benign cases and healthy subjects （P 〈 0.01 ）. According to the detection value of health control group, the cut- off value was 695 mg/L, the sensitivity was 69.00%, the specificity was 88.90%, Negative predictive value and positive predictive value were 72.07% and 87.34% respectively, The total efficiency was 78.4%. The level of serum sialic acid in adenocarcinoma, squamous cell carcinoma, adenosquamous carcinoma and undifferentiated carci- noma were （845 ±91）mg/L, （782±91）mg/L, （794± 126） mg/L and （831 ± 113） mg/L,respectively. The con- tent of serum sialic acid in malignant tumor cases of different histopathology types is apparently higher than of the control （P 〈0.01 ）. While there is no significance between different histopathology types （P 〉 0.05 ）. The values increased gradually with higher tumor grade and stage. Conclusion Biochemical analysis of sialic acid can be used in screening, diagnosis, curative effect assessment, monitoring and early detection of non-small cell lung cancer.