Abstract：Objective: To explore the diagnostic value of combined detection of serum Src homology domain 2 protein B1 (SH2B1), Nedd4 family interacting protein 1 (NDFP1), and α-hydroxybutyrate dehydrogenase (α-HBDH) in differentiating benign and malignant solitary pulmonary nodules (SPN). Methods: Totally 260 SPN patients in our hospital were designated as the SPN group, and were classified into a benign group (112 cases) and a malignant group (148 cases) based on pathological examination results. Meanwhile, 200 healthy individuals were made the control group. The ELISA method was used to detect serum SH2B1, NDFIP1, and α-HBDH. Multivariate logistic regression was used to explore the risk factors affecting SPN malignancy. Relative risk analysis of serum SH2B1, NDFIP1, and α-HBDH levels on malignant transformation of SPN. ROC curve was plotted to evaluate the differential diagnostic value of serum SH2B1, NDFIP1, and α-HBDH for benign and malignant SPN. Results: Compared with the control group, the SPN group had higher serum SH2B1 and α-HBDH (t=46.344, 28.857, P<0.05), and lower NDFIP1 (t=26.385, P<0.05). The malignant group had higher serum SH2B1 and α-HBDH than the benign group (t=6.877, 6.705, P<0.05), and lower NDFIP1 than the benign group (t=6.959, P<0.05). Multivariate logistic regression analysis revealed that spiny nodule morphology (OR=3.613, 95%CI: 1.182~7.203), solid nodules (OR=4.079, 95%CI: 1.410~11.801), elevated SH2B1 levels (OR=2.440, 95%CI: 1.290~4.614), and high α-HBDH expression (OR=2.228, 95%CI: 1.346~3.687) were independent risk factors for SPN malignancy, whereas high NDFIP1 expression (OR=0.724, 95%CI: 0.559~0.938) was a protective factor (P<0.05). Relative risk analysis further indicates that patients with high levels of SH2B1 and high levels of α-HBDH have a 2.498-fold and 2.424-fold increased risk of developing malignant SPN, respectively, compared to those with low levels; whereas patients with high levels of NDFIP1 had a risk that was 0.492 times lower than that of patients with low levels. The AUC for the combined diagnosis of malignant SPN using serum SH2B1, NDFIP1, and α-HBDH was 0.919, which was superior to the combined diagnosis using nodule morphology and nodule characteristics (Zcombined-nodule morphology + nodule characteristics=4.611, P<0.001). Conclusion: The changes in serum SH2B1, NDFIP1, and α-HBDH are closely related to the benign and malignant natures of SPN. All three have certain differential diagnostic value for benign and malignant SPN, and combined detection has high differential diagnostic efficacy.
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2026, Vol. 32 
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