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血胱抑素C等对肺癌患者化疗过程中肾损伤的评价
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  • 分类:R446.1[医药卫生—诊断学;医药卫生—临床医学]
  • 作者机构:天津医科大学肿瘤医院检验科,国家肿瘤临床医学研究中心,天津市“肿瘤防治”重点实验室,天津市恶性肿瘤临床医学研究中心,天津300060
  • 相关基金:基金项目国家自然科学基金资助项目(81201653,81502519)
中文摘要:

目的:评价血清胱抑素C(CysC)、肌酐(Cr)、尿素(urea)、β2-微球蛋白(β2-MG)在肺癌患者化疗期间肾损伤中的意义。方法:收集443例肺癌并接受化疗的患者,检测血Cr,urea,β2-MG,CysC的浓度水平;同时测定^99Tc^m-DTPA的清除率(rGFR)作为评价肾功能的金标准。分析不同化疗周期中各指标的变化,并将血Cr,urea,β2-MG,CysC与rGFR加以比较。结果:在化疗过程中,血CysC较其他3个指标能更早地发现肾功能的受损情况,在化疗1周期后就有明显升高(P〈0.05);任何化疗周期,CysC都与rGFR相关性最高;在各肾功能分期,CysC的异常检出率均最高;CysC诊断准确度,Youden指数和受试者工作曲线下面积(AUC)均最高,且CysC敏感性最高。结论:血清CysC是评价肺癌患者化疗期间肾功能损害的最敏感、可靠的指标。

英文摘要:

Objective: To evaluate the significance of serum cystatin C (CysC), creatinine (Cr), urea and β2 microglobulin (β2-MG) in kidney function damage for patients with lung cancer during chemotherapy. Methods: Concentrations of Cr, urea, β2-MG, CysC were tested among 443 patients with lung cancer, meanwhile clearance of ^99Tc^m-DTPA (rGFR) was detected as gold standard of renal function. The index changes in different cycles of chemotherapy were analyzed and compared with rGFR. Results: CysC detected renal injury earlier than the other three, and were increased significantly after 1 cycle of chemotherapy; CysC was the most highly correlated with rGFR in different cycles of chemotherapy; rates of abnormal of CysC was the highest in every GFR stage; and the highest diagnostic accuracy, Youden index, area under ROC curve and sensitivity were all obtained from CysC. Conclusion: Serum CysC may be the most sensitive and reliable index to evaluate of renal injury during chemotherapy in patients with lung cancer.

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