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中华肺部疾病杂志(电子版)

中华肺部疾病杂志(电子版) ›› 2023, Vol. 16 ›› Issue (01) : 39 -42. doi: 10.3877/cma.j.issn.1674-6902.2023.01.008

论著

Cho/Cr比值联合NSE对肺癌脑转移/骨转移的预后意义
左剑辉1,†(), 陈宇1, 尹纯同1   
  1. 1. 230022　合肥，安徽医科大学第一附属医院胸外科
  • 收稿日期:2022-09-14 出版日期:2023-02-25
  • 通信作者: 左剑辉
  • 基金资助:
    安徽省自然科学基金青年项目(1608085QH215)

Prediction of efficacy and prognosis of Cho/Cr ratio combined with serum NSE in patients with lung cancer brain metastases/bone metastases

jianhui Zuo1,†(), Yu Chen1, Chuntong Yin1   

  1. 1. Department of Thoracic Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022 China
  • Received:2022-09-14 Published:2023-02-25
  • Corresponding author: jianhui Zuo
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左剑辉, 陈宇, 尹纯同. Cho/Cr比值联合NSE对肺癌脑转移/骨转移的预后意义[J]. 中华肺部疾病杂志(电子版), 2023, 16(01): 39-42.

jianhui Zuo, Yu Chen, Chuntong Yin. Prediction of efficacy and prognosis of Cho/Cr ratio combined with serum NSE in patients with lung cancer brain metastases/bone metastases[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2023, 16(01): 39-42.

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。

关键词: Cho/Cr比值, 神经元特异性烯醇化酶, 肺癌脑转移/骨转移, 预后质量
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.

Key words: Cho/Cr ratio, Neuron-specific enolase, Lung cancer brain/bone metastases, Prognostic quality
表1 两组Cho/Cr及NSE水平检测结果(±s)
组　别 例数 Cho/Cr NSE(ng/ml)
单纯组 79 23.82±4.12 26.95±3.84
多发转移组 42 53.12±6.27 35.19±5.02
t值   27.312 8.060
P值   0.000 0.000
表2 Cho/Cr及NSE联合预测患者预后模型
指　标 B S.E χ2 P值 OR 95%CI
下限 上限
Cho/Cr 0.621 0.214 8.421 0.004 1.861 1.223 2.830
NSE 0.619 0.199 9.676 0.002 1.857 1.257 2.743
常数项 0.592 0.201 8.675 0.003 1.808 1.219 2.680
图1 ROC曲线图
表3 Cho/Cr及NSE单独及联合预测患者预后
指　标 敏感度 特异度 AUC S.E P值 95%CI
下限 上限
Cho/Cr 88.61 83.33 0.872 0.039 0.000 0.796 0.949
NSE 87.34 85.71 0.878 0.034 0.000 0.811 0.945
联合应用 96.20 95.24 0.957 0.022 0.000 0.914 1.000
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