循环肿瘤细胞联合血清CCL25、MECOM检测在肺小结节病变性质中的诊断价值-东南大学学报医学版

循环肿瘤细胞联合血清CCL25、MECOM检测在肺小结节病变性质中的诊断价值

单位：1. 皖北煤电集团总医院呼吸内科, 安徽宿州 234000;
2. 皖北煤电集团总医院胸外科, 安徽宿州 234000;
3. 皖北煤电集团总医院病理科, 安徽宿州 234000

关键词：循环肿瘤细胞 CC趋化因子配体25 MDS1和EVI1复合位点肺小结节诊断

分类号：R734.2

出版年·卷·期（页码）：2025·44·第四期（580-586）

摘要：

目的:探究循环肿瘤细胞联合血清CC趋化因子配体25(CCL25)、MDS1和EVI1复合位点(MECOM)检测在肺小结节病变性质中的诊断价值。方法:选取2021年11月至2023年11月99例单发肺部小结节患者为研究对象,其中经病理结果证实为肺小结节恶性患者(67例)为恶性组,良性病变者(32例)为良性组。采用免疫磁性分离法检测循环肿瘤细胞结果;酶联免疫吸附法检测血清样本CCL25、MECOM水平;绘制受试者工作特征(ROC)曲线分析循环血清CCL25、MECOM水平对恶性肺小结节病变的诊断价值。采用四格表χ²检验法分析血清CCL25、MECOM水平诊断恶性肺小结节病变效能;多因素Logistic分析肺小结节发生恶变的影响因素。结果:肺小结节恶性组患者循环肿瘤细胞阳性率、血清CCL25水平较良性组患者升高,MECOM水平下降(均P＜0.05);ROC曲线表明血清CCL25水平诊断恶性肺小结节病变的曲线下面积(AUC)为0.847,MECOM水平诊断的AUC为0.881;四格表 χ²检验法分析三者联合诊断灵敏度、特异度、准确率、阴性预测值显著高于单独诊断(均P＜0.05);多因素Logistic分析结果表明,循环肿瘤细胞和血清CCL25水平是肺小结节恶性病变的危险因素,MECOM水平是保护因素(P＜0.05)。结论:肺小结节恶性病变患者循环肿瘤细胞阳性率、血清CCL25水平较高,血清MECOM水平下降,三者联合对肺小结节病变性质诊断价值较大。

Objective: To explore the diagnostic value of circulating tumor cells combined with serum CC chemokine ligand 25(CCL25), MDS1 and EVI1 complex locus protein(MECOM) detection for the nature of pulmonary nodules lesions. Methods: From November 2021 to November 2023, 99 patients with solitary pulmonary nodules were selected as the study subjects, with pathological results confirming 67 cases as the malignant group and 32 cases as the benign group. The results of circulating tumor cells were detected by immunomagnetic separation. Serum levels of CCL25 and MECOM were detected by enzyme-linked immunosorbent assay. Receiver operating characteristic(ROC) curves were plotted to analyze the diagnostic value of circulating serum CCL25 and MECOM levels for malignant pulmonary nodules. The Chi-square test using a fourfold table method was used to analyze the efficacy of serum CCL25 and MECOM levels in diagnosing malignant pulmonary nodules; multiple Logistic regression analysis was performed to identify factors influencing the malignancy of pulmonary nodules. Results: The positive rate of circulating tumor cells and serum CCL25 levels were higher in the malignant group than those in the benign group, while MECOM levels were lower(all P<0.05). The ROC curve indicated that the area under the curve(AUC) value for serum CCL25 level diagnosis of malignant pulmonary nodules was 0.847, and the AUC value for MECOM level diagnosis was 0.881. The Chi-square test analysis revealed that the combined diagnosis of the three had significantly higher sensitivity, specificity, accuracy and negative predictive value compared to single diagnosis(all P<0.05). Multiple Logistic regression analysis results indicated that circulating tumor cells and serum CCL25 levels were risk factors for malignant pulmonary nodules, while MECOM levels were protective factors(P<0.05). Conclusion: The positive rate of circulating tumor cells and serum CCL25 level are higher in patients with malignant lesions of pulmonary nodules, while serum MECOM level is lower. The combination of three has great diagnostic value for pulmonary nodules.

参考文献：

[1] MAZZONE P J,LAM L.Evaluating the patient with a pulmonary nodule:a review[J].JAMA,2022,327(3):264-273.
[2] OWENS C,HINDOCHA S,LEE R,et al.The lung cancers:staging and response,CT,18F-FDG PET/CT,MRI,DWI:review and new perspectives[J].Br J Radiol,2023,96(1148):20220339-20220354.
[3] LIN D,SHEN L,LUO M,et al.Circulating tumor cells:biology and clinical significance[J].Signal Transduct Target Ther,2021,6(1):404-428.
[4] 蒋浩,曹新超,吴桐,等.低剂量CT联合外周血循环肿瘤细胞在肺癌早期诊断中的价值研究[J].中国CT和MRI杂志,2024,22(6):57-60.
[5] WU X,SUN M,YANG Z,et al.The roles of CCR9/CCL25 in inflammation and inflammation-associated diseases[J].Front Cell Dev Biol,2021,9(1):686548-686559.
[6] 周宇,皇改改.血清PDCD5、CCL25联合检测对肺癌的早期诊断价值[J].国际检验医学杂志,2024,45(18):2286-2289.
[7] TANG Z,WANG W,YANG S,et al.3q26.2/MECOM rearrangements by pericentric inv(3):diagnostic challenges and clinicopathologic features[J].Cancers(Basel),2023,15(2):458-473.
[8] LI A,LI M,WANG J,et al.MECOM:a bioinformatics and experimentally identified marker for the diagnosis and prognosis of lung adenocarcinoma[J].Biomark Med,2024,18(2):79-91.
[9] 中华医学会呼吸病学分会间质性肺疾病学组,中国医师协会呼吸医师分会间质性肺疾病工作委员会.中国肺结节病诊断和治疗专家共识[J].中华结核和呼吸杂志,2019,42(9):685-693.
[10] YAO Y,WANG X,GUAN J,et al.Metabolomic differentiation of benign vs malignant pulmonary nodules with high specificity via high-resolution mass spectrometry analysis of patient sera[J].Nat Commun,2023,14(1):2339-2351.
[11] MA X B,XU Q L,LI N,et al.A decision tree model to distinguish between benign and malignant pulmonary nodules on CT scans[J].Eur Rev Med Pharmacol Sci,2023,27(12):5692-5699.
[12] 石婕,刘璇,明宗娟,等.细胞因子与肿瘤标志物联合检测对孤立性肺结节良恶性鉴别诊断的价值[J].中国肺癌杂志,2021,24(6):426-433.
[13] LI Z,CAI J,ZHAO Y,et al.Folate receptor-positive circulating tumor cells in the preoperative diagnosis of indeterminate pulmonary nodules[J].J Clin Lab Anal,2022,36(10):e24654.
[14] XIE Q,LIU S,ZHANG S,et al.Research progress on the multi-omics and survival status of circulating tumor cells[J].Clin Exp Med,2024,24(1):49-64.
[15] DONATO C,KUNZ L,CASTRO-GINER F,et al.Hypoxia triggers the intravasation of clustered circulating tumor cells[J].Cell Rep,2020,32(10):108105-108129.
[16] XIA D,WANG S,LIU A,et al.CCL25 inhibition alleviates sepsis-induced acute lung injury and inflammation[J].Infect Drug Resist,2022,15(1):3309-3321.
[17] LI J,ZHAO C,WANG D,et al.ZIM3 activation of CCL25 expression in pulmonary metastatic nodules of osteosarcoma recruits M2 macrophages to promote metastatic growth[J].Cancer Immunol Immunother,2023,72(4):903-916.
[18] YU H,MEI Y,DONG Y,et al.CCR9-CCL25 mediated plasmacytoid dendritic cell homing and contributed the immunosuppressive microenvironment in gastric cancer[J].Transl Oncol,2023,33(1):101682-101692.
[19] XIN Z,LIN M,HAO Z,et al.The immune landscape of human thymic epithelial tumors[J].Nat Commun,2022,13(1):5463-5467.
[20] LV J,MENG S,GU Q,et al.Epigenetic landscape reveals MECOM as an endothelial lineage regulator[J].Nat Commun,2023,14(1):2842-2859.
[21] LI M,REN H,ZHANG Y,et al.MECOM/PRDM3 and PRDM16 serve as prognostic-related biomarkers and are correlated with immune cell infiltration in lung adenocarcinoma[J].Front Oncol,2022,12(1):772686-772701.
[22] VOIT R A,SANKARAN V G.MECOM deficiency:from bone marrow failure to impaired B-cell development[J].J Clin Immunol,2023,43(6):1052-1066.
[23] LAN N,BAI S,CHEN M,et al.MECOM locus classical transcript isoforms affect tumor immune microenvironment and different targets in ovarian cancer[J].J Ovarian Res,2024,17(1):207-220.

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