| Objective To observe the diagnostic value of serum homocysteine(Hcy)and cystatin C(Cystatin C,Cys-C)levels in lung cancer patients,and to investigate the correlation between the the levels of Hcy,Cys-C and severity of lung cancer.To analyze the efficacy and renal impairment after chemotherapy for lung cancer patients through Hcy and Cys-C.Methods The experiment including 240 cases of lung cancer patients and 98 healthy controls which were both enrolled at the same time.Then we analyzed the difference between the lung cancer groups and healthy groups in the factors of age,sex,smoking,tumor family history,lung cancer family history,and serum Hcy and Cys-C levels.The lung cancer group were divided into four stage : phase I,phaseII,phaseIII,and phase IV according to TNM.The differences of serum Hcy and Cys-C levels between different stages were compared,and the correlation between Hcy and Cys-C levels and tumor stage were analyzed.The serum levels of Hcy and Cys-C were compared before and after chemotherapy in patients with lung cancer treated with chemotherapy.The patients with chemotherapy lung cancer were divided into two groups according to the curative effect and the poor efficacy group.The differences of serum Hcy and Cys-C levels between the two groups were compared.The patients in the chemotherapy group were divided into the combined group of renal impairment and the group without renal impairment according to the presence of renal impairment,and the difference of the levels of Hcy and Cys-C between the two groups was compared.The sensitivity and specificity of serum Hcy,Cys-C and Hcy+Cys-C in the diagnosis of lung cancer were analyzed.Results 1.The serum Hcy and Cys-C in the group of lung cancer patients show a higher level than those of the controls(P < 0.05).At the same time,there was a significant difference in the number of people who smoked of the two groups.The results of Spearman correlation analysisshowed that serum level of Hcy and Cys-C had significant correlation with lung cancer(P < 0.05).2.The serum level of Hcy in the four different stage from stage I to stage IV were 17.61 ± 2.63umol/L,20.96 ± 3.79umol/L,27.81 ± 4.87umol/L,34.85 ± 5.13umol/L respectively;The serum level of Cys-C in the four different stage from stage I to stage IV were 1.35 ± 0.23mg/L,1.66 ± 0.31mg/L,2.02 ± 0.38 mg/L,2.73 ± 0.49 mg/L respectively.There were significant differences in Hcy(F=25.212,P<0.001)and Cys-C levels(F=19.324,P<0.001)between the four groups.Hcy and Cys-C increased with the increase of stage.The concentration increased correspondingly,and the difference between the two groups was statistically significant(P<0.05).The serum levels of Hcy and Cys-C were positively correlated with the pathological stage of lung cancer(r = 0.968,r = 0.975,P<0.05).3.173 lung cancer patients were treated with chemotherapy,the serum levels of Hcy and Cys-C were significantly lower than those before chemotherapy(P<0.05).Among the 173 lung cancer patients,98 cases were better effective,and 75 cases were less effective.The concentration of Hcy and Cys-C in the patients with better efficacy were significantly lower than that of the poorly treated group,and the difference was statistically significant(P<0.05).4.Of the 173 patients with chemotherapy,38 had renal dysfunction after chemotherapy and 135 had no renal dysfunction.Before chemotherapy,the serum Hcy levels of patients with lung cancer and renal dysfunction were 25.51±3.24umol/L and 24.31±4.78umol/L,respectively,and the difference was not statistically significant(P>0.05).The serum Cys-C levels in the group and the non-renal dysfunction group were 3.75±0.73 mg/L and 1.68±0.49 mg/L,respectively,and there were significant differences between the two groups(P<0.05).5.The sensitivity of serum Hcy combined with Cys-C in detecting lung cancer was significantly higher than that of single detection(89.7% vs.80.6%,83.3%).Conclusion 1.Serum homocysteine and Cystatin C levels in lung cancer patients were significantly higher than normal.2.Serum homocysteine and Cystatin C levels increase with the severity of lung cancer staging,which can be used as an indicator to reflect the severity of lung cancer;3.Serum homocysteine and Cystatin C levels are significantly decreased after chemotherapy for lung cancer,which can be used to monitor the efficacy of chemotherapy for lung cancer;4.Serum homocysteine and Cystatin C levels after lung cancer chemotherapy can predict the efficacy of chemotherapy to some extent.5.Serum Cystatin C levels increase in the concentration of chemotherapy patients with renal dysfunction,which can be used as an indicator of renal function damage after chemotherapy.6.Combined detection of serum homocysteine and Cystatin C can improve the sensitivity of diagnosis of lung cancer.7.Serum homocysteine and cysteine-C are clinically useful serological markers for the diagnosis of lung cancer and post-chemotherapy. |
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