| 摘要: |
| ［摘要］ 目的 探讨血清潜在转化生长因子β结合蛋白2（LTBP2）、细胞骨架相关蛋白4（CKAP4）水平对孤立性肺结节良恶性鉴别诊断的效能。方法 招募2021年3月至2024年3月东台市人民医院收治的孤立性肺结节患者140例。其中68例为良性病变（良性组），72例为恶性病变（恶性组）。于同期招募100名健康者作为对照组。于患者入院次日清晨（对照组于健康体检时）采集空腹静脉血4 mL，通过酶联免疫吸附试验检测血清LTBP2、CKAP4水平。采用Pearson相关分析恶性组血清LTBP2水平与CKAP4水平的相关性。比较良性组和恶性组的临床资料，通过logistic回归分析影响孤立性肺结节恶性病变发生的因素。采用受试者工作特征（ROC）曲线分析血清LTBP2、CKAP4水平鉴别诊断孤立性肺结节良恶性的效能。结果 良性组和恶性组血清LTBP2、CKAP4水平高于对照组，且恶性组较良性组更高，差异有统计学意义（P<0.05）。Pearson相关分析结果显示，恶性组血清LTBP2水平与CKAP4水平呈正相关（r=0.485，P<0.001）。多因素logistic回归分析结果显示，较高的血清LTBP2［OR（95%CI）=8.807（2.933～26.446），P<0.001］、CKAP4［OR（95%CI）=5.281（1.902～14.662），P=0.001］水平是促进恶性孤立性肺结节发生的独立危险因素。ROC曲线分析结果显示，血清LTBP2、CKAP4水平均可有效鉴别诊断孤立性肺结节的良恶性（P<0.05），且两指标联合诊断的效能优于单一指标（Z两指标联合-LTBP2=2.225，P=0.026；Z两指标联合-CKAP4=1.980，P=0.047），灵敏度为94.44%，特异度为75.00%。结论 血清LTBP2、CKAP4水平检测有助于鉴别诊断孤立性肺结节的良恶性，且两指标联合检测的诊断效能较单一指标更优。 |
| 关键词: 孤立性肺结节 潜在转化生长因子β结合蛋白2 细胞骨架相关蛋白4 鉴别诊断 |
| DOI：10.3969/j.issn.1674-3806.2026.04.12 |
| 分类号:R 563.9 |
| 基金项目: |
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| The diagnostic value of serum LTBP2 and CKAP4 levels in differentiating benign and malignant solitary pulmonary nodules |
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LI Yanmei, YAO Jun
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Department of Respiratory and Critical Care Medicine, Dongtai People′s Hospital, Yancheng 224200, China
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| Abstract: |
| ［Abstract］ Objective To explore the diagnostic efficacy of serum latent-transforming growth factor beta-binding protein 2(LTBP2) and cytoskeleton-associated protein 4(CKAP4) levels in differentiating benign and malignant solitary pulmonary nodules. Methods A total of 140 patients with solitary pulmonary nodules who were admitted to Dongtai People′s Hospital from March 2021 to March 2024 were recruited. Among them, there were 68 cases of benign lesions(benign group), and 72 cases of malignant lesions(malignant group). During the same period, 100 healthy individuals were recruited as control group. On the early morning of the next day after admission(for the control group, during the health check-up), 4 mL of fasting venous blood was collected from each research subject. The levels of serum LTBP2 and CKAP4 were detected by using enzyme-linked immunosorbent assay(ELISA). The correlation between serum LTBP2 and CKAP4 levels in the malignant group was analyzed by using Pearson correlation. The clinical data were compared between the benign group and the malignant group. The factors influencing the occurrence of malignant lesions of solitary pulmonary nodules were analyzed by using logistic regression. Receiver operating characteristic(ROC) curve was used to analyze the diagnostic efficacy of serum LTBP2 and CKAP4 levels in differentiating benign and malignant solitary pulmonary nodules. Results The levels of serum LTBP2 and CKAP4 in the benign group and the malignant group were higher than those in the control group, and the levels of the two indicators in the malignant group were higher than those in the benign group, with statistically significant differences(P<0.05). The results of Pearson correlation analysis showed that the serum LTBP2 level was positively correlated with the CKAP4 level in the malignant group(r=0.485, P<0.001). The results of multivariate logistic regression analysis showed that higher levels of serum LTBP2［OR(95%CI)=8.807(2.933-26.446), P<0.001］ and CKAP4［OR(95%CI)=5.281(1.902-14.662), P=0.001］ were independent risk factors for promoting the occurrence of malignant solitary pulmonary nodules. The results of ROC curve analysis showed that the levels of serum LTBP2 and CKAP4 could be effective in differential diagnosis of benign and malignant solitary pulmonary nodules(P<0.05), and the diagnostic efficacy of the combination of the two indicators was better than that of a single indicator(Zcombination of the two indicators-LTBP2=2.225, P=0.026; Zcombination of the two indicators-CKAP4=1.980, P=0.047), with a sensitivity of 94.44% and a specificity of 75.00%. Conclusion The detection of serum LTBP2 and CKAP4 levels is helpful for differential diagnosis of benign and malignant solitary pulmonary nodules, and the combined detection of the two indicators has a better diagnostic efficacy than a single indicator. |
| Key words: Solitary pulmonary nodules Latent-transforming growth factor beta-binding protein 2(LTBP2) Cytoskeleton-associated protein 4(CKAP4) Differential diagnosis |
