血清骨代谢指标变化对肺癌患者骨转移的诊断治疗及预后评估的应用价值

目的 探讨血清骨代谢指标变化对肺癌患者骨转移的诊断、治疗及预后评估的应用价值。 方法 选取永康市中医院收治的初诊肺癌患者108例,其中58例为骨转移组,50例为无骨转移组,选取同期健康体检人员50例为对照组。检测治疗前、后3组研究对象总Ⅰ型前胶原氨基端前肽(TPINP)、骨钙素N端中分子片段(N-MID)水平。 结果 治疗前骨转移组与无骨转移组TPINP、N-MID水平明显高于对照组(P<0.05),且骨转移组TPINP、N-MID水平明显高于无骨转移组(P<0.05);TPINP、N-MID诊断肺癌患者骨转移的AUC分别为0.887、0.701,二者比较差异有统计学意义(P<0.05);治疗后明显缓解的患者TPINP、N-MID水平较治疗前明显下降(P<0.05),未见缓解或加重的患者TPINP、N-MID水平与治疗前差异无统计学意义(P>0.05),且明显缓解的患者TPINP、N-MID水平明显低于未见缓解或加重患者(P<0.05);TPINP>72.36 μg/L患者的中位生存时间明显高于TPINP ≤ 72.36 μg/L的患者(P<0.05);N-MID>17.58 μg/L的患者和N-MID ≤ 17.58 μg/L患者的中位生存时间比较差异无统计学意义(P>0.05)。 结论 TPINP、N-MID水平可作为肺癌患者骨转移诊断、疗效评估的有效指标,其中TPINP对肺癌患者的预后评估具有一定作用。 

The value of bone metabolic indexes in the diagnosis,treatment and prognosis evaluation of bone metastases in patients with lung cancer

Objective To explore the value of bone metabolic indexes in the diagnosis, treatment and prognosis evaluation of bone metastases in patients with lung cancer. Methods A total of 108 patients with lung cancer in Yongkang Hospital of Traditional Chinese Medicine were selected, 58 patients with bone metastasis of lung cancer were included in the bone metastasis group, 50 patients without bone metastases were included in the boneless metastasis group, and 50 healthy people in the same period were included in the control group. The levels of total type procollagen Ⅰ amino-terminal propeptide (TPINP) and N-terminal molecular fragments of osteocalcin (N-MID) before and after treatment in the three groups were compared. Results The levels of TPINP and N-MID in the bone metastasis group and boneless metastasis group were significantly higher than those in control group (P<0.05), and the levels of TPINP and N-MID in bone metastasis group were significantly higher than those in boneless metastasis group (P<0.05). The AUC of TPINP and N-MID in the diagnosis of bone metastases in patients with lung cancer were 0.887 and 0.701 respectively, there was a significant difference between the two groups (P<0.05). The levels of TPINP and N-MID in relieved patients after treatment were significantly lower than those before treatment (P<0.05). There was no significant difference in TPINP and N-MID levels between patients without remission or worsening before and after treatment (P>0.05). The levels of TPINP and N-MID in relieved patients were significantly lower than those of patients without remission or worsening (P<0.05). The median survival time of patients with TPINP>72.36 μg/L was significantly higher than that of patients with TPINP ≤ 72.36 μg/L (P<0.05). There was no significant difference in the median survival time between the patients with N-MID>17.58 μg/L and N-MID ≤ 17.58 μg/L. Conclusion The levels of TPINP and N-MID can be used as effective indicators for the diagnosis and treatment evaluation of bone metastases in patients with lung cancer, and TPINP has a certain effect on the prognosis of patients with lung cancer.