| OBJECTIVE:Based on the expression levels of IL-32 and IL-21 in the serum of patients with non-small cell lung cancer(NSCLC),the expression levels of IL-32 and IL-21 as well as the correlation between typing of lung cancer(adenocarcinoma,squamous carcinoma)and TNM staging were analyzed,and the CEA and CYFRA21-1 as serum tumor markers were simultaneously detected,thus to draw a receiver operating characteristic curve(ROC),hoping to provide some reference for early diagnosis and severity evaluation of NSCLC.METHODS:40 patients who were diagnosed with NSCLC in the respiratory medicine department of the second hospital of Jilin university from June 2017 to December2018 were randomly recruited to form the observation group,and 20 healthy volunteers who received physical examination in the outpatient clinic of our hospital were recruited to form the control group.The enzyme-linked immunosorbent assay(ELISA)was used to determine the expression levels of IL-32 and IL-21 in serum of receivers,and the expression levels of CEA and CYFRA21-1 in serum were detected in the clinical lab of the second hospital of Jilin university,SPSS22.0 software was used for statistical analysis,and the results were statistically significant at P < 0.05.RESULTS:1.The expression levels of CEA [4.65(2.25,27.53)vs 1.72(1.57,2.94)ng/ml]、CYFRA21-1[5.20(2.47,30.38)vs 1.86(1.73,3.25)ng/ml] 、 IL-32[141.79±18.88 vs128.71±22.85 pg/ml]、IL-21[82.25±18.00 vs 70.08±9.18pg/ml] in serum of patients with NSCLC were significantly higher than those of the control group,the difference was statistically significant(P<0.05).2.Among patients with NSCLC,the expression level of IL-32 in serum of patients with lung squamous cell carcinoma was significantly lower than that of patients with lung adenocarcinoma [134.04±17.70 vs 149.54±17.08pg/ml],the difference was statistically significant(P<0.05),The expression level of IL-21 in serum of patients with lung squamous cell carcinoma was significantly higher than that of patients with adenocarcinoma [90.00±16.11 vs 74.51±16.72pg/ml],the difference was statistically significant(P<0.05).3.The expression level of IL-32 in the serum of patients with NSCLC was positively correlated with clinical staging,and the difference was statistically significant(P<0.05);the expression level of IL-21 was negatively correlated with clinical staging,the difference was statistically significant(P<0.05).4.Drawing a ROC curve for each index including IL-32,IL-21,CEA and CYFRA21-1 for analysis:(1)The AUC of IL-21 was 0.688(95% CI: 0.557-0.819,P<0.05),the diagnostic cutoff value was 79.33 ng/L,the diagnostic sensitivity and specificity were respectively 55.0% and 90.0%.(2)The AUC of 2IL-32 was 0.661(95% CI: 0.507-0.815,P<0.05),the diagnostic cutoff value was 106.13 ng/L,the diagnostic sensitivity and specificity were respectively 100.0% and 30.0%.(3)The AUC of 3CYFRA21-1 was 0.788(95% CI: 0.671-0.905,P<0.05),the diagnostic cutoff value was 3.545 ng/ml,the diagnostic sensitivity and specificity were respectively 67.5% and 85.0%.(4)The AUC of 4CEA was 0.791(95% CI:0.674-0.907,P<0.05),the diagnostic cutoff value was 3.255 ng/ml,the diagnostic sensitivity and specificity were respectively 67.5% and 85.0%.5.Further ROC curves were drawn by randomly combining two of the IL-32,IL-21,CEA and CYFRA21-1 to comprehensively analyze the sensitivity and specificity,the three groups with high diagnostic efficiency were:(1)The AUC of1IL-32+IL-21 was 0.878(95% CI: 0.769-0.986,P<0.05),the sensitivity and specificity were respectively 90.0% and 75.0%;(2)The AUC of 2CYFRA21-1+CEA was 0.874(95% CI: 0.780-0.967,P<0.05),sensitivity and specificity wererespectively 82.5% and 90.0%;(3)The AUC of 3IL-21+CYFRA21-1 was 0.858(95%CI: 0.761-0.954,P<0.05),sensitivity and specificity were respectively 77.5% and90.0%.6.Further ROC curves were drawn by randomly combining multiple of the IL-32,IL-21,CEA and CYFRA21-1 to comprehensively analyze the sensitivity and specificity,the two groups with higher diagnostic efficiency were:(1)The AUC of1IL-32+IL-21+CYFRA21-1 was 0.931(95% CI: 0.858-1.000,P<0.05),the sensitivity and specificity were respectively 92.5% and 85.0.The AUC of2IL-32+IL-21+CYFRA21-1+CEA was 0.931(95% CI: 0.865-0.997,P<0.05),the sensitivity and specificity were respectively 85.0% and 90.0%.Combining with economic analysis,it is concluded that the IL-32+IL-21+CYFRA21-1 has the highest value for diagnose of NSCLC.CONCLUSION:1.The expression levels of IL-32 and IL-21 in serum of patients with NSCLC were significantly higher than those in normal people,and there were significant differences in lung adenocarcinoma and lung squamous cell carcinoma,which were related to the tumor development.Therefore,IL-32 and IL-21 maybe helpful to the type of tissue and prognosis of patients with NSCLC.2.Joint detection of IL-32+IL-21+CYFRA21-1 may improve the sensitivity and specificity of NSCLC screening,which can effectively reduce misdiagnosis or missed diagnosis. |
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