中国全科医学2017，Vol.20Issue(15)：1823-1828,6.DOI:10.3969/j.issn.1007-9572.2017.15.008
血清生长分化因子15水平在肺癌的诊断及化疗疗效评估中的价值研究
Value of Serum GDF-15 level on Diagnosis and Evaluation of Chemotherapy Efficacy for Lung Cancer
摘要
Abstract
Objective To study the role of serum growth differentiation factor-15(GDF-15) as a diagnostic marker and a chemotherapy response predictor in lung cancer so as to provide a clinical reference.Methods The participants met the inclusion criteria of this study were all selected from the First Affiliated Hospital of Anhui Medical University,included 88 inpatients with lung cancer(lung cancer group) and 31 inpatients with pneumonia(pneumonia group) treated in Department of Respiratory Medicine,and 41 healthy controls(normal control group) undergoing health examination in Medical Examination Center,between December 2015 and August 2016.The serum GDF-15 level was measured in both lung cancer and pneumonia groups on the day of admission and in the normal control group on the first day of undergoing health examination.We collected the lung cancer group′s data of smoking history,diabetes history,measurement results of laboratory markers such as hemoglobin(HGB),prealbumin(PA) and lactate dehydrogenase(LDH) and pathological features(T staging,N staging,clinical staging and pathological types of lung cancer),pneumonia and lung cancer groups′ data of measurement results of serum GDF-15,carcinoembryonic antigen(CEA),neuronspecific enolase(NSE) and cytokeratin 19 fragment(CYFRA21-1) levels.ROC curve of serum GDF-15,CEA,NSE and CYFRA21-1 levels for the diagnosis of lung cancer was evaluated,respectively.In lung cancer patients who completed two consecutive cycles of chemotherapy,chemotherapy response was evaluated and serum GDF-15 level was measured for assessing the chemotherapy response.Results Normal control group had lower serum GDF-15 level than pneumonia group and lung cancer group(P<0.05).Lung cancer group had higher serum GDF-15 level than the pneumonia group(P<0.05).In the lung cancer group,patients with BMI ≥24 kg/m2 had higher serum GDF-15 levels than those with BMI <24 kg/m2(P<0.05);patients with diabetes had higher serum GDF-15 levels than those without(P<0.05),patients with lower serum HGB levels had higher serum GDF-15 levels than those with normal serum HGB levels(P<0.05);Stage T1-2 lung cancer patients had lower serum GDF-15 levels than stage T3-4 lung cancer patients(P<0.05).For the diagnosis of lung cancer,the serum GDF-15 level′s cut off value,sensitivity,specificity,area under the ROC curve(AUC) value,Youden′s index were 1 199.05 ng/L,78.2%,71.0%,0.851〔95%CI(0.774,0.910)〕 and 0.492,respectively.Serum GDF-15 had higher AUC value than serum CEA〔0.630,95%CI(0.537,0.717)〕,NSE〔0.720,95%CI(0.631,0.799)〕 and CYFRA21-1〔0.654,95%CI(0.561,0.739)〕 for the prediction of lung cancer(P<0.05).In the 64 lung cancer cases completing two consecutive cycles of chemotherapy,the condition was partially relieved in 11 cases,stable in 33 cases,and progressive in 20 cases;There was significant difference in serum GDF-15,CEA levels in lung cancer group with different therapeutic effects after chemotherapy(P <0.05).There was no significant difference in serum NSE and CYFRA21-1 levels in lung cancer group with different therapeutic effects after chemotherapy(P>0.05).Conclusion Serum GDF-15 can be used as a diagnostic marker,and a promising new chemotherapy response predictor in lung cancer.关键词
肺肿瘤/生长分化因子15/诊断/化疗疗效评估/灵敏度/特异度Key words
Lung neoplasms/Growth differentiation factor 15/Diagnosis/Evaluation of chemotherapy efficacy/Sensitivity/Specificity分类
医药卫生引用本文复制引用
邓静静,徐爱晖..血清生长分化因子15水平在肺癌的诊断及化疗疗效评估中的价值研究[J].中国全科医学,2017,20(15):1823-1828,6.基金项目
国家公益性行业科研专项(201302003) （201302003）
