5′-NT及其与ALT联合检测在鉴别ALP升高的恶性肿瘤骨转移中的价值

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摘要目的研究血清5′核苷酸酶（5′-NT）及其与丙氨酸氨基转移酶（ALT）联合检测在鉴别血清碱性磷酸酶（ALP）升高的恶性肿瘤骨转移中的价值。方法选取2018年12月~2019年8月中国医学科学院北京协和医学院肿瘤医院就诊恶性肿瘤患者176例。其中血清ALP水平升高但无骨转移患者88例为ALP升高肝癌组；血清ALP水平升高但其余肝功能指标均正常的骨转移患者88例为ALP升高恶性肿瘤骨转移组；同期选取健康志愿者50名为正常对照组。测定三组血清5′-NT及ALT水平。结果 ALP升高肝癌组5′-NT阳性率高于ALP升高恶性肿瘤骨转移组（P < 0.01），ALP升高肝癌组血清5′-NT水平高于ALP升高恶性肿瘤骨转移组及正常对照组（P < 0.01）。血清5′-NT或ALT水平升高为ALP升高恶性肿瘤患者骨转移的保护因素。5′-NT判断ALP升高为恶性肿瘤骨转移的曲线下面积（AUC）为0.966，当临界值＜5.6 U/L，灵敏度为90.91%，特异性为89.77%；5′-NT联合ALT检测时AUC为0.980，特异度可提高至96.49%。结论 5′-NT及ALT联合检测在鉴别ALP升高的恶性肿瘤骨转移中具有一定的临床价值。

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	崔婵娟高佳李佳于梦瑶张浩崔巍▲

关键词 ： 5&prime, 核苷酸酶, 碱性磷酸酶, 肿瘤, 骨转移

Abstract：Objective To explore the value of serum 5′-nucleotidase (5′-NT) and its combination with alanine aminotransferase (ALT) in identifying bone metastases in cancer patients with elevated alkaline phosphatase (ALP). Methods A total of 176 cancer patients who enrolled from Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from December 2018 to August 2019 were selected. Among them, 88 cases with elevated ALP but without bone metastasis were named the liver cancer with elevated ALP group; other 88 cases with bone metastasis and elevated ALP but normal liver function were named the cancer with bone metastasis and elevated ALP group; 50 healthy volunteers were named the normal control group at the same time. The levels of serum 5′-NT and ALT were detected in three groups. Results The positive rate of 5′-NT in the liver cancer with elevated ALP group was higher than that in the cancer with bone metastasis and elevated ALP group (P < 0.01). The serum levels of 5′-NT in liver cancer with elevated ALP group were higher than those in the cancer with bone metastasis and elevated ALP group and the normal control group (P < 0.01). The increased serum 5′-NT or ALT levels were protective factors for bone metastases in cancer patients with elevated ALP. The area under the curve (AUC) of 5′-NT to judge the elevation of ALP to malignant tumor bone metastasis was 0.966, and the sensitivity was 90.91% and the specificity was 89.77% when the critical value was < 5.6 U/L. The AUC of 5′-NT combined with ALT was 0.980, and the specificity was increased to 96.49%. Conclusion The combined detection of 5′-NT and ALT has a certain clinical value in differentiating bone metastases of malignant tumors with elevated ALP.

Key words： 5′-nucleotidase Alkaline phosphates Cancer Bone metastases

基金资助:国家自然科学基金面上项目（81772272）；
中国医学科学院医学与健康科技创新工程（2017-I2M-3-005）。

通讯作者: ▲通讯作者

作者简介: 崔婵娟（1986-），女，博士；研究方向：肿瘤及出凝血。

引用本文:

崔婵娟高佳李佳于梦瑶张浩崔巍▲. 5′-NT及其与ALT联合检测在鉴别ALP升高的恶性肿瘤骨转移中的价值[J]. 中国医药导报, 2020, 17(17): 109-112.
CUI Chanjuan GAO Jia LI Jia YU Mengyao ZHANG Hao CUI Wei▲. The value of serum 5′-nucleotidase and its combination with alanine aminotransferase in identifying bone metastases in cancer patients with elevated ALP. 中国医药导报, 2020, 17(17): 109-112.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I17/109

[1] 府伟灵，徐克前.临床生物化学检验[M].北京：北京人民卫生出版社，2013.
[2] Cortini M，Baldini N，Avnet S. New Advances in the Study of Bone Tumors：A Lesson from the 3D Environment [J]. Front Physiol，2019，10：814.
[3] Lang J，Zhao Q，He Y，et al. Bone turnover markers and novel biomarkers in lung cancer bone metastases [J]. Biomarkers，2018，23（6）：518-526.
[4] Demers LM，Costa L，Lipton A. Biochemical markers and skeletal metastases [J]. Cancer，2000，88（12 Suppl）：2919-2926.
[5] Xin Y，Han B，Lou J，et al. Diagnostic value of bone metabolic markers ICTP and BAP in lung cancer patients with bone metastases [J]. Zhongguo Fei Ai Za Zhi，2010， 13（10）：947-953.
[6] Castoldi E，Cappella A，Gibelli D，et al. The Difficult Task of Diagnosing Prostate Cancer Metastases on Dry Bone [J]. J Forensic Sci，2018，63（3）：672-682.
[7] Pinski J，Dorff TB. Prostate cancer metastases to bone：pathophysiology，pain management，and the promise of targeted therapy [J]. Eur J Cancer，2005，41（6）：932-940.
[8] Costa L，Demers LM，Gouveia-Oliveira A，et al. Prospective evaluation of the peptide-bound collagen type I cross-links N-telopeptide and C-telopeptide in predicting bone metastases status [J]. J Clin Oncol，2002，20（3）：850-856.
[9] Yang M，Liu C，Yu X. Skeletal-related adverse events during bone metastasis of breast cancer：current status [J]. Discov Med，2019，27（149）：211-220.
[10] Wang S，Li GX，Tan CC，et al. FOXF2 reprograms breast cancer cells into bone metastasis seeds [J]. Nat Commun，2019，10（1）：2707.
[11] Quayle L，Ottewell PD，Holen I. Bone Metastasis：Molecular Mechanisms Implicated in Tumour Cell Dormancy in Breast and Prostate Cancer [J]. Curr Cancer Drug Targets，2015，15（6）：469-480.
[12] Gowda S，Desai PB，Hull V，et al. A review on laboratory liver function tests [J]. Pan Afr Med J，2009， 3：17.
[13] Hyder MA，Hasan M，Mohieldein A. Comparative Study of 5′-Nucleotidase Test in Various Liver Diseases [J]. J Clin Diagn Res，2016，10（2）：BC01-BC03.
[14] Raghavendra DS，Rao SB. Studies on some serum enzyme levels in various liver diseases [J]. Indian J Clin Biochem，2000，15（1）：48-51.
[15] Fernandez NJ，Kidney BA. Alkaline phosphatase：beyond the liver [J]. Vet Clin Pathol，2007，36（3）：223-233.
[16] 伍建蓉，郑玲，杨红，等.血清骨型碱性磷酸酶对于恶性肿瘤骨转移的诊断价值[J]. 临床肿瘤学杂志，2010，15（11）：1007-1010.
[17] Woreta TA，Alqahtani SA. Evaluation of abnormal liver tests [J]. Med Clin North Am，2014，98（1）：1-16.
[18] Subhani TF，Nasar MA，Gupta RP，et al. Oxidative stress，antioxidant status and 5′-nucleotidase activity in chronic hepatitis c and alcoholic patients [J]. J Biomed Pharm Res，2015，4（1）：38-45.
[19] Shim JJ，Kim JW，Oh CH，et al. Serum alanine aminotransferase level and liver-related mortality in patients with chronic hepatitis B：A large national cohort study [J]. Liver Int，2018，38（10）：1751-1759.
[20] Sookoian S，Pirola CJ. Liver enzymes，metabolomics and genome-wide association studies：from systems biology to the personalized medicine [J]. World J Gastroenterol，2015，21（3）：711-725.