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KL-6在非小细胞肺癌术后辅助治疗性肺损伤中的诊断价值

吴丽娜 高弋 李沃松 刘勇 秦晓松

吴丽娜, 高弋, 李沃松, 刘勇, 秦晓松. KL-6在非小细胞肺癌术后辅助治疗性肺损伤中的诊断价值[J]. 协和医学杂志, 2021, 12(4): 496-502. doi: 10.12290/xhyxzz.2021-0308
引用本文: 吴丽娜, 高弋, 李沃松, 刘勇, 秦晓松. KL-6在非小细胞肺癌术后辅助治疗性肺损伤中的诊断价值[J]. 协和医学杂志, 2021, 12(4): 496-502. doi: 10.12290/xhyxzz.2021-0308
WU Li'na, GAO Yi, LI Wosong, LIU Yong, QIN Xiaosong. Application Value of Serum Kreb Von Den Lungen-6 in the Adjuvant Treatment of Lung Injury after Non-small Cell Lung Cancer Surgery[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(4): 496-502. doi: 10.12290/xhyxzz.2021-0308
Citation: WU Li'na, GAO Yi, LI Wosong, LIU Yong, QIN Xiaosong. Application Value of Serum Kreb Von Den Lungen-6 in the Adjuvant Treatment of Lung Injury after Non-small Cell Lung Cancer Surgery[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(4): 496-502. doi: 10.12290/xhyxzz.2021-0308

KL-6在非小细胞肺癌术后辅助治疗性肺损伤中的诊断价值

doi: 10.12290/xhyxzz.2021-0308
基金项目: 

国家卫生健康委科学技术研究所重大专项 2021KYSHX00601

详细信息
    通讯作者:

    秦晓松  电话:024-96615-72128,E-mail: qinxs@sj-hospital.org

  • 中图分类号: R446.62

Application Value of Serum Kreb Von Den Lungen-6 in the Adjuvant Treatment of Lung Injury after Non-small Cell Lung Cancer Surgery

Funds: 

Science and Technology of National Health Commission 2021KYSHX00601

More Information
  • 摘要:   目的  探讨血清涎液化糖链抗原-6(kreb von den lungen-6,KL-6)在非小细胞肺癌(non-small cell lung cancer,NSCLC)术后辅助治疗性肺损伤中的诊断价值。  方法  回顾性收集2017年11月—2020年7月中国医科大学附属盛京医院诊治的NSCLC患者(包括术后采用辅助治疗者和仅手术者)资料,以药物诱导性肺损伤(drug induced lung injury, DILI)、放射性肺损伤(radiation induced lung injury, RILI)诊断共识为判断NSCLC术后辅助治疗性肺损伤的诊断标准,将NSCLC术后辅助治疗患者分为肺损伤组和无肺损伤组,仅手术者为NSCLC手术组;以年龄和性别匹配同期体检中心的健康成人为健康对照组。肺损伤组于肺损伤确诊当日,无肺损伤组于辅助治疗的第3~4个月,NSCLC手术组分别于术前、术后7~10 d,健康对照组于体检当日,空腹采集静脉血检测血清KL-6。比较各组血清KL-6差异,并以无肺损伤组为对照,采用受试者工作特征(receiver operating characteristic,ROC)曲线评估血清KL-6诊断NSCLC术后辅助治疗性肺损伤的效能。  结果  共206例符合纳入和排除标准的患者入选本研究,其中肺损伤组51例,无肺损伤组52例,NSCLC手术组103例;健康对照组103例,基线资料均衡可比。血清KL-6水平由高至低依次为肺损伤组[512.40(322.30,819.20)kU/L]、NSCLC手术组(术前) [204.40(162.70,283.20)kU/L]、健康对照组[177.70(154.20,206.40)kU/L]、无肺损伤组[147.80(114.25,229.80)kU/L]和NSCLC手术组(术后) [143.80(111.90,247.80)kU/L]。除无肺损伤组与NSCLC手术组术后血清KL-6无统计学差异(P=0.879)外,其余两两比较差异均有统计学意义(P均<0.05)。ROC曲线分析显示,血清KL-6诊断NSCLC术后辅助治疗性肺损伤的曲线下面积(area under the curve,AUC)为0.972(95%CI:0.948~0.997),灵敏度、特异度、阳性似然比、阴性似然比分别为86.3%(95% CI:73.0%~94.1%)、96.2%(95% CI:86.2%~98.7%)、22.43(95% CI:5.74~87.69)、0.14(95% CI:0.07~0.28),最佳诊断临界值为310.15 kU/L。  结论  NSCLC术后辅助治疗性肺损伤患者血清KL-6显著升高,其在NSCLC术后辅助治疗性肺损伤中具有较高的诊断价值,但仍需大样本前瞻性研究进一步验证。
    作者贡献:吴丽娜、秦晓松负责研究设计、数据分析、论文撰写;高弋、李沃松负责标本留取及临床资料收集;刘勇指导研究设计、数据分析及修改论文。
    利益冲突:
  • 图  1  NSCLC患者术后辅助治疗性肺损伤组、无肺损伤组患者筛选流程图

    NSCLC: 非小细胞肺癌;HRCT: 高分辨率计算机断层扫描

    图  2  患者血清KL-6水平比较

    NSCLC: 同图 1;KL-6:涎液化糖链抗原-6

    图  3  血清KL-6诊断NSCLC患者术后辅助治疗性肺损伤的ROC曲线图

    NSCLC: 同图 1;KL-6:同图 2;ROC: 受试者工作特征

    表  1  患者一般资料比较

    指标 肺损伤组(n=51) 无肺损伤组(n=52) NSCLC手术组(n=103) 健康对照组(n=103) P
    年龄(x±s, 岁) 58.51±7.14 53.06±8.70 59.26±7.08 54.61±8.90 <0.001
    性别(男/女,n) 33/18 32/20 66/37 62/41 0.926
    病理类型(腺癌/鳞癌,n) 43/8 40/12 82/21 - 0.634
    TNM分期(Ⅱ/Ⅲ期,n) 23/28 27/25 48/55 - 0.756
    术后辅助治疗方式(单纯放疗/同步放化疗,n) 18/33 17/35 - - 0.780
    合并慢性阻塞性肺疾病[n(%)] 4(7.84) 1(1.92) 3(2.91) 0(0) 0.037
    合并结缔组织病[n(%)] 1(1.96) 0(0) 0(0) 0(0) 0.166
    NSCLC:同图 1;-:不适用
    下载: 导出CSV
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  • 收稿日期:  2021-04-06
  • 录用日期:  2021-06-08
  • 刊出日期:  2021-07-30

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