摘要
目的:分析Cho/Cr比值联合神经元特异性烯醇化酶(neuron-specific enolase, NSE)对肺癌脑转移/骨转移疗效及预测意义。方法:选择2016年1月至2022年1月我院收治的60例肺癌脑转移和61例骨转移患者，按预后分为单纯组79例和多发转移组42例。治疗结束一周行磁共振MRS检查，计算肿瘤实质区胆碱/肌酸(Cho/Cr)水平，检测患者NSE水平。结果:单纯组Cho/Cr为(23.82±4.12)，NSE为(26.95±3.84) ng/ml；多发转移组Cho/Cr为(53.12±6.27)，NSE为(35.19±5.02 )ng/ml。单纯组Cho/Cr及NSE水平低于多发转移组(P<0.05)；Cho/Cr及NSE与患者预后，OR分别为1.861(95%CI：1.223~2.830)和1.857(95%CI：1.257~2.743)，P<0.05；Cho/Cr及NSE联合预测预后质量模型为log(P)＝0.621×Cho/Cr+0.619×NSE+0.592；单独Cho/Cr预测灵敏度，特异度及AUC分别为88.61，83.33和0.872，单独NSE预测灵敏度，特异度及AUC分别为87.34，85.71和0.878，Cho/Cr及NSE联合预测灵敏度，特异度及AUC分别为96.20，95.24和0.957。Cho/Cr及NSE联合应用预测肺癌脑转移/骨转移预后质量的敏感度、特异度及AUC明显高于单独应用指标(P<0.05)。结论:Cho/Cr比值联合NSE与肺癌脑转移/骨转移患者疗效呈正相关，Cho/Cr比值联合NSE预测患者预后具有临床意义。
Abstract
Objective:To analyze the efficacy and predictive significance of Cho/Cr ratio combined with neuron-specific enolase (NSE) in lung cancer patients with brain metastases and bone metastases.Methods:60 patients with brain metastases and 61 patients with bone metastases of lung cancer admitted to our hospital from January 2016 to January 2022 were selected and divided into simple group 79 cases and multiple metastatic group 42 cases according to prognosis. MRS was performed one week after treatment, choline/creatine (Cho/Cr) levels in tumor parenchyma were calculated, and NSE levels were detected.Results:Cho/Cr was (23.82±4.12) and NSE was (26.95±3.84) ng/ml in simple group. Cho/Cr was (53.12±6.27) and NSE was (35.19±5.02) ng/ml in multiple metastasis group. The levels of Cho/Cr and NSE in simple group were lower than those in multiple metastasis group (P<0.05). Cho/Cr and NSE were positively correlated with the prognosis of patients, OR was 1.861 (95%CI: 1.223~2.830) and 1.857(95%CI: 1.257~2.743), respectively (P<0.05). The combined prediction model of Cho/Cr and NSE was log (P) =0.621×Cho/Cr+ 0.619×NSE+ 0.592. Prediction sensitivity, specificity and AUC of Cho/Cr alone were 88.61, 83.33 and 0.872, respectively; prediction sensitivity, specificity and AUC of NSE alone were 87.34, 85.71 and 0.878, respectively; prediction sensitivity of Cho/Cr and NSE combined. Specificity and AUC were 96.20, 95.24 and 0.957, respectively. The sensitivity, specificity and AUC of Cho/Cr and NSE combined in predicting the prognostic quality of lung cancer with BMS/bone metastases were significantly higher than those of single application (P<0.05).Conclusions:Cho/Cr ratio combined with NSE is positively correlated with the curative effect of lung cancer patients with brain metastases/bone metastases. Cho/Cr ratio combined with NSE can predict the quality of prognosis of patients better than that of index alone.
基金项目
安徽省自然科学基金青年项目(1608085QH215)
万方数据