摘要
目的 探讨同型半胱氨酸(Hcy)、中性粒细胞/淋巴细胞比值(NLR)、血管内皮生长因子C(VEGF-C)、细胞角蛋白19片段抗原21-1(CYFRA21-1)联合检测对非小细胞肺癌(NSCLC)淋巴结转移的预测价值.方法 回顾性收集2019年5月至2024年1月于界首市人民医院行肺癌根治性切除术的NSCLC患者73例,其中淋巴结转移40例作为淋巴结转移组,未转移33例作为未转移组.收集所有患者年龄、性别、吸烟指数、病变部位、病理类型、肿瘤分化程度资料.收集患者术前Hcy、NLR、VEGF-C、CYFRA21-1水平.采用受试者操作特征(ROC)曲线分析血液Hcy、NLR、VEGF-C、CYFRA21-1水平及联合检测对NSCLC淋巴结转移的预测价值.结果 NSCLC淋巴结转移与年龄、性别构成比、病变部位、肿瘤分化程度无关(P＞0.05);NSCLC淋巴结转移与吸烟指数、病理类型有关,差异均有统计学意义(P＜0.05).与未转移组相比,淋巴结转移组 Hcy 水平[(18.15±3.59)μmol/L vs.(12.64±3.14)μmol/L]、NLR 水平(4.02±1.03 vs.1.84±0.47)、VEGF-C 水平[(142.65±22.64)pg/mL vs.(104.37±18.67)pg/mL]、CYFRA21-1水平[(11.63±3.02)ng/mL vs.(7.08±2.46)ng/mL]均较高,差异均有统计学意义(P＜0.05).淋巴结转移NSCLC患者血液中Hcy、NLR、VEGF-C、CYFRA21-1水平分别与吸烟指数、病理类型有关(P＜0.05).ROC曲线结果显示,四者联合对诊断NSCLC淋巴结转移的AUC为0.929,敏感度为78.60％,特异度为95.00％.结论 NSCLC淋巴结转移患者血液中Hcy、NLR、VEGF-C、CYFRA21-1水平明显升高,联合检测血液中Hcy、NLR、VEGF-C、CYFRA21-1水平可提高NSCLC淋巴结转移的预测价值,对NSCLC淋巴结转移的早期诊断具有重要意义.
Abstract
Objective To investigate the predictive value of combined detection of homocysteine(Hey),neutrophil/lymphocyte ratio(NLR),vascular endothelial growth factor C(VEGF-C)and cytokeratin 19 fragment antigen 21-1(CYFRA21-1)for non-small cell lung cancer(NSCLC)lymph node metastasis.Methods A total of 73 patients with NSCLC who underwent radical resection of lung cancer in Jieshou People's Hospital from May 2019 to January 2024 were retrospectively collected.Among them,40 cases with lymph node metastasis were taken as the lymph node metastasis group,and 33 cases without metastasis were taken as the non-metastasis group.The data of age,sex,smoking index,lesion location,pathological type and tumor differentiation degree of all patients were collected.The levels of Hey,NLR,VEGF-C and CY-FRA21-1 were collected before operation.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of blood Hcy,NLR,VEGF-C,CYFRA21-1 and combined detection for lymph node metastasis in NSCLC.Results The lymph node metastasis of NSCLC was not related to age,sex ratio,lesion location and tumor differentiation(P＞0.05).The lymph node metastasis of NSCLC was related to smoking index and pathological type,and the difference was statistically significant(P＜0.05).Compared with the non-metastasis group,the levels of Hcy[(18.15±3.59)μmol/Lvs.(12.64±3.14)μmol/L],NLR(4.02±1.03vs.1.84±0.47),VEGF-C[(142.65±22.64)pg/mLvs.(104.37±18.67)pg/mL]andCYFRA21-1[(11.63±3.02)ng/mL vs.(7.08±2.46)ng/mL]in the lymph node metastasis group were higher,the differences were statistically significant(P＜0.05).The levels of Hey,NLR,VEGF-C and CYFRA21-1 in the blood of NSCLC patients with lymph node metastasis were related to smoking index and pathological type(P＜0.05).ROC curve results showed that the AUC of the combination of the four for the diagnosis of NSCLC lymph node metastasis was 0.929,the sensitivity was 78.60％,and the speci-ficity was 95.00％.Conclusion The blood levels of Hcy,NLR,VEGF-C and CYFRA21-1 in patients with NSCLC lymph node metastasis are significantly increased.Combined detection of blood levels of Hcy,NLR,VEGF-C and CYFRA21-1 can improve the predictive value for NSCLC lymph node metastasis,which is of great significance for the early diagnosis of lymph node metastasis in NSCLC.
基金项目
安徽省红十字会中医药传承创新发展研究项目(2022ZYYD11)
NETL
NSTL
万方数据