Clinical Value Of Serum Thymidine Kinase 1 In The Diagnosis Of Pulmonary Nodules

Objective:To explore the expression level of serum thymidine kinase 1(TK1)in benign and malignant pulmonary nodules,and to provide reference for the differentiation of the nature of pulmonary nodules.Methods:The clinical data of 135 patients with pulmonary nodule who were hospitalized in the Second Hospital of Hebei Medical University from January 1,2019 to December 31,2020 were collected.According to the postoperative pathological results,they were divided into malignant nodule group(106 cases)and benign nodule group(29 cases).The age,gender,smoking history,COPD history,pulmonary nodule location,pulmonary nodule size,TK1,WBC,PLT,NLR,PLR of the two groups were statistically analyzed.According to the presence or absence of COPD,the patients were divided into pulmonary nodule group and pulmonary nodule combined with stable COPD group.The characteristics of pulmonary nodules,TK1,WBC,PLT,NLR,PLR of the two groups were statistically analyzed.Results:1.There were 135 patients with pulmonary nodules in this study.There were 29 cases of benign pulmonary nodules,accounting for 21.5%,including21 cases of inflammatory nodules,4 cases of hamartoma and 4 cases of tuberculosis.There were 106 cases of malignant pulmonary nodules,including73 cases of adenocarcinoma,24 cases of squamous cell carcinoma,8 cases of small cell carcinoma and 1 case of sarcomatoid carcinoma.The two groups had statistically significant differences in age(P=0.002),lung nodule size(P=0.002),and TK1 level(P=0.029).There was no significant difference in gender,smoking history,COPD history,pulmonary nodule location,WBC,PLT,NLR and PLR between the two groups(P>0.05).2.In this study,there were 102 cases in pulmonary nodule group and 33cases in pulmonary nodule combined with stable COPD.Pulmonary nodule group:22 cases(21.6%)were benign,80 cases(78.4%)were malignant;pulmonary nodule combined with COPD group:7 cases(21.2%)were benign,26 cases(78.8%)were malignant.There was no significant difference in nature of pulmonary nodules,TK1,WBC,PLT,NLR,PLR between the two groups(P>0.05).3.Multivariate logistic regression analysis showed that age(OR=1.082,P<0.05)and pulmonary nodule size(OR=0.090,P<0.05)were independent forecast factors for malignant pulmonary nodules.4.Establish a prediction model for malignant pulmonary nodules:P=e~x/(1+e~x),X=-5.304+(0.079×age)+(0.090×pulmonary nodule size).The results of testing the diagnostic efficacy of the model show that the AUC was0.776,the sensitivity was 86.8%,the specificity was 58.6%,the Youden index was 0.454,and the cutoff value was 0.68.Hosmer-lemeshow goodness of fit test,χ2=6.487,P=0.593(P>0.05),the results show that the model has good predictive accuracy in the diagnosis of benign and malignant pulmonary nodules.Conclusions:1.The benign and malignant pulmonary nodules are related to age,lung nodule size,and TK1 level.The older the age,the larger the pulmonary nodule and the higher the TK1 level,the higher the possibility of malignant pulmonary nodule.2.TK1 can be used as a serum biomarker for early screening and diagnosis of malignant pulmonary nodules.3.The serum TK1 level was not affected in stable COPD patients.4.The prediction model has good sensitivity and specificity in the prediction of diagnosis of malignant pulmonary nodules,which can improve the accuracy of early diagnosis of malignant pulmonary nodules.