| Objective:The expression levels of serum alkaline phosphatase(ALP),cystatin C(Cys-C)and CEA in patients with non-small cell lung cancer were detected,and the specificity and sensitivity of the three in the diagnosis of NSCLC were compared.To clarify the diagnostic value of the changes of serum ALP and Cys-C levels in NSCLC.To explore the diagnostic value of serum ALP and Cys-C levels in NSCLC and their correlation with tumor progression.To analyze the efficacy after chemotherapy for non-small cell lung cancer patients through ALP and Cys-C.Methods:1.Eighty-two patients with NSCLC admitted from the Second Affiliated Hospital of Nanchang University from January 2018 to June 2018 were selected.All NSCLC patients were newly treated patients.We selected 66 cases of benign lung diseases and 15 cases of normal physical examination in physical examination center.2.The differences in the levels of ALP,Cys-C and CEA between NSCLC group,benign lung disease group and healthy physical examination group were analyzed.Compare whether the expression levels of serum ALP and Cys-C in NSCLC group differed by gender,age,pathological type and smoking index.Patients in NSCLC group were divided into stages ?,?,? ,and ? according to the TNM staging criteria for malignant tumors,of which stage ? and ? were a group,and stage ? and ? were a group.The ALP and Cys-C indexes of the two groups were compared,and the correlation analysis of ALP,Cys-C and tumor stage were carried out.Patients in the NSCLC group were divided into groups based on the presence or absence of lymph node metastasis and distant metastasis,and compared the differences in serum ALP and Cys-C expression levels,and analyze the correlation between ALP,Cys-C and tumor lymph node metastasis and distant metastasis respectively.3.All patients had their blood taken before treatment,the specificity and sensitivity of combined detection of serum ALP,Cys-C and ALP,Cys-C,CEA in the diagnosis of non-small cell lung cancer were analyzed.Of the 82 NSCLC patients,60 were treated with platinum-based chemotherapy.Compare the differences of serum ALP and Cys-C expression levels in 60 lung cancer patients before and after chemotherapy.The patients with chemotherapy were divided into effective and ineffective groups according to their efficacy,then compare the ALP and Cys-C levels between the two groups.Results:1.The concentration of ALP in the serum of NSCLC group [(117.8±45.8)U/L] was much higher than that in benign pulmonary disease group [(68.5 ±14.0)U/L] and healthy physical examination group [(64.6±17.8)U/L].There were statistically significant differences(P<0.001).The concentration of Cys-C in the serum of NSCLC group[(1.2±0.5)mg/L] was much higher than that in benign pulmonary disease group [(0.8±0.3)mg/L] and healthy physical examination group [(0.8 ± 0.2)mg/L],there were statistically significant differences(P <0.001).2.No significant differences were observed in serum ALP and Cys-C in NSCLC patients of different ages,genders,smoking status and pathological types.The expression levels of serum ALP and Cys-C were significantly correlated with tumor stage,lymph node metastasis and distant metastasis.The specific manifestation is that the serum ALP level in the NSCLC group was significantly higher in patients with stage ?-? than in patients with stage ?-?(127.7±47.5U/L vs 87.9±22.0 U/L,P = 0.003).The level of ALP in lymph node metastasis was much higher than that in no lymph node metastasis group(125.8± 47.8U/L vs 97.3±33.4U/L,P = 0.012).Serum ALP was much higher in patients with distant metastases than in those without distant metastases(132.0±47.6 U/L vs 104.5±40.4 U/L,P = 0.019).The level of Cys-C in patients with stage ?-? was significantly higher than that in patients with stage ?-?(1.3±0.4 mg/L vs 0.9±0.2 mg/L,P = 0.002).Serum Cys-C was significantly higher in patients with lymph node metastasis than in those without lymph node metastasis(1.3±0.5 mg/L vs 1.0 ±0.2mg/L,P = 0.005).Serum Cys-C was significantly higher in patients with distant nodal metastasis than in those without distant metastasis(1.4±0.5 mg/L vs 1.0 ± 0.3mg/L,P = 0.001).There was obvious relationship between serum ALP and Cys-C levels and tumor stage,lymph node metastasis,and distant metastasis(r = 0.461,r =?0.332,r = ?0.378,P <0.05),(r = 0.506),R = ?0.389,r = ?0.484,P<0.05).3.The best cutoff values of serum ALP,Cys-C and CEA for diagnosis of NSCLC were 88.69u/l,0.90mg/l and 2.25ng/l.AUC under ROC curve were 0.835(95% CI = 0.759-0.911,P<0.001),0.842(95% CI = 0.765-0.920,P<0.001),0.788(95% CI = 0.698-0.878,P<0.001).The sensitivity of the three areas was 70%,81.7%,73.3%,and the specificity was 85.4%,75.6%,82.9%.The specificity of the combined detection is better than single detection.In the joint detection,the sensitivity of ALP,Cys-C,and CEA was the highest(90%),and the specificity of the combined detection of ALP + CEA is the highest(78%).4.All 60 lung cancer patients had been treated with chemotherapy after diagnosis.The serum ALP and Cys-C concentrations after treatment were significantly lower than before chemotherapy(P<0.05).Serum ALP and Cys-C concentration levels can be used to evaluate the chemotherapy effect of patients.The specific manifestations are: 38 of 60 chemotherapy patients have good efficacy and 22 patients have poor efficacy.Comparing the levels of serum ALP and Cys-C between the two groups,the group with better efficacy was significantly lower than the group with poor efficacy(P <0.05).Conclusion:1.The combined detection of serum ALP and Cys-c is helpful to improve the positive rate of diagnosis.2.The expression levels of serum ALP and Cys-c in NSCLC group were significantly correlated with tumor stage,lymph node metastasis and distant metastasis,suggesting that ALP and Cys-c may be closely related to the invasion and metastasis of lung cancer and other malignant behaviors.3.The serum ALP and Cys-c concentrations decreased significantly after chemotherapy in the NSCLC group,which could be used to monitor the efficacy of chemotherapy for non-small cell lung cancer. |
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