肺癌患者测定血清 APOA、APOB、LP（a）和生物标志物水平的临床价值

摘要

Objective To explore the clinical value of the determination of serum APOA, APOB, LP(a) and biomarkers in patients with lung cancer. Methods The serum level of APOA, APOB, LP(a), CRP, BNP and CTnI in 156 patients with lung cancer were determined by turbidimetry and radioimmunoassa. The value of each index in diagnosis of lung cancer was analyzed by ROC curve. Results The serum level of APOA was significantly lower in 156 patients with lung cancer than those in 60 controls (P < 0. 01), but the serum levels of APOB, LP(a), CRP, BNP and CTnI were significantly higher in the study group than in the control group, increasing with the severity of lung adeno-carcinoma. The ROC curve analysis for predicting early diagnosis showed that the area under the ROC curve lung aden-carcinoma for APOB was 0. 687, and the sensitivity was 51. 6% and the specificity was 68. 4% , but the sensitivity and specificity of LP ( a), CRP and BNP were 0. 716, 3. 3% and 70. 6% , 0. 814, 65. 8% and 75. 3% , 0. 720, 56. 7% and 71. 8% respectively. Conclusion The determination of serum APOB, LP(a), CRP and BNP is helpful for the early diagnosis of lung adeno-carcinoma, and the serum CRP level is best for the early di-agnosis.%目的：为了探讨肺癌患者测定血清 APOA(apoprotein A,APOA)、APOB(apoprotein B,APOB)、LP(a)[lipoprotein(a),LP(a)]和生物标志物水平的临床价值。方法采用比浊法和放射免疫分析156例肺癌患者血清 APOA、APOB、LP( a)、CRP( c-reative protein,CRP)、BNP( brain natriuretic peptide,BNP)和 CTnI (cardiac troponin I,CTnI)水平并进行对比性分析。受试者工作特征曲线(ROC 曲线)评价肺腺癌早期诊断的预测价值。结果156例肺癌血清 APOA 水平较之60例正常对照组降低(P <0．01),而血清 APOB、LP(a)、CRP、BNP 和 CTnI 水平明显增高(P <0．01~<0．001),并随肺腺癌患者Ⅰ~Ⅱ期至Ⅲ~Ⅳ期严重程度的增加而增高。 ROC 曲线分析显示：APOB 评估肺腺癌早期诊断的曲线下面积(AUC)为0．687、灵敏度51．6%、特异度68．4%；LP ( a)为0．716、53．3%和70．6%； CRP 为0．854、65．8%和75．3%； BNP 为0．720、56．7%和71．8%,并以 CRP 为最好。结论血清 APOB、LP(a)、CRP 和 BNP 水平测定是肺腺癌早期诊断的辅助指标,并以血清 CRP 水平为好。