fa نقش بیوانفورماتیک در شناسایی بیومارکرهای سرطانی با تأکید بر پیامدهای اقتصادی و مدیریت تشخیصی درمانی تخصصي Special مروری Review Article <span style="font-size:11pt"><span style="line-height:150%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">هدف</span></span></span></b><b><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:" var="">:</span></span></span></b> <span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">این مطالعه با هدف ارزیابی عملکرد زیست‌نشانگرهای تومور</span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:" var=""> CA-125</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">، </span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:" var="">PSA</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">، </span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:" var="">HER2</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">، </span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:" var="">AFP </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">و</span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:" var=""> NMP22 </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">در تشخیص، پایش و پیش‌بینی پاسخ به درمان سرطان و همچنین تحلیل تأثیر اقتصادی آن‌ها بر سیستم سلامت طراحی شده است</span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:" var="">.</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:150%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">روش‌ها</span></span></span></b><b><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:" var="">: </span></span></span></b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">داده‌های </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">۱۱۷۰</span></span></span> <span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">بیمار از مطالعات بالینی مختلف جمع‌آوری و با نرم‌افزار</span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:" var=""> SPSS </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">تحلیل شد. شاخص‌های حساسیت و اختصاصیت محاسبه و با تحلیل منحنی</span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:" var=""> ROC </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">و روش‌های بیوانفورماتیک تکمیل گردید. برای مقایسه گروه‌ها از آزمون‌های</span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:" var=""> t </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">مستقل، کای-اسکوئر و</span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:" var=""> ANOVA </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">استفاده شد</span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:" var="">.</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:150%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">نتایج</span></span></span></b> <b><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:" var="">:</span></span></span></b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">با حساسیت </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">۸۵</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times="">٪</span></span></span> <span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">و اختصاصیت </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">۹۰</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times="">٪</span></span></span> <span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">بالاترین عملکرد تشخیصی را داشت</span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:" var="">. HER2 </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">با </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">۷۸</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times="">٪</span></span></span> <span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">بهبود در درمان هدفمند و </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">۴۰</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times="">٪</span></span></span> <span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">کاهش هزینه درمانی، مؤثرترین زیست‌نشانگر از نظر بالینی و اقتصادی بود. سایر زیست‌نشانگرها</span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:" var=""> CA-125 </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">با </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">۶۲</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times="">٪</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">، </span></span></span>&nbsp;<span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:" var="">AFP </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">با </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">۷۲</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times="">٪</span></span></span> <span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">و</span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:" var=""> NMP22 </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">با </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">۶۵</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times="">٪</span></span></span> <span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">بهبود نقش مکمل در تشخیص و پایش بیماری داشتند. تحلیل مسیرهای سیگنال‌دهی نشان داد</span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:" var=""> PI3K/AKT </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">مسیر مشترک</span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:" var=""> CA-125 </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">و</span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:" var=""> NMP22 </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">در مقاومت به درمان است</span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:" var="">.</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:150%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">بحث</span></span></span></b><b><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:" var="">: </span></span></span></b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">از منظر بیمه سلامت، پوشش تست‌های زیست‌نشانگرها ضمن بهبود دقت تشخیصی و کیفیت درمان، با کاهش هزینه‌های بستری و درمان‌های غیرهدفمند، در بلندمدت منجر به صرفه‌جویی قابل توجه در منابع سیستم بهداشت و درمان می‌شود</span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:" var="">.</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:150%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">نتیجه‌گیری</span></span></span></b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">: زیست‌نشانگرهای مطالعه‌شده ابزاری کارآمد در مدیریت بالینی سرطان هستند و گنجاندن آن‌ها در بسته‌های پوشش بیمه سلامت، رویکردی مقرون‌به‌صرفه برای سیستم درمان محسوب می‌شود.</span></span></span></span></span></span></span></span><br> &nbsp; Abstract<br> Objective: This study was designed to evaluate the performance of tumor biomarkers CA-125, PSA, HER2, AFP, and NMP22 in diagnosing, monitoring, and predicting response to cancer treatment, as well as analyzing their economic impact on the health system.<br> Methods: Data from 1,170 patients from different clinical studies were collected and analyzed with SPSS software. Sensitivity and specificity indices were calculated and supplemented with ROC curve analysis and bioinformatics methods. Independent t-tests, chi-square, and ANOVA were used to compare groups.<br> Results: It had the highest diagnostic performance with a sensitivity of 85% and a specificity of 90%. HER2 was the most effective biomarker clinically and economically with a 78% improvement in targeted therapy and a 40% reduction in treatment costs. Other biomarkers, CA-125 with a 62% improvement, AFP with a 72% improvement, and NMP22 with a 65% improvement had a complementary role in diagnosing and monitoring the disease. Analysis of signaling pathways showed that PI3K/AKT is a common pathway of CA-125 and NMP22 in treatment resistance.<br> Discussion: From a health insurance perspective, coverage of biomarker tests improves diagnostic accuracy and treatment quality, reduces hospitalization costs and non-targeted treatments, and leads to significant savings in health system resources in the long term.<br> Conclusion: The studied biomarkers are an efficient tool in the clinical management of cancer, and their inclusion in health insurance coverage packages is considered a cost-effective approach for the treatment system. سرطان, بیوانفورماتیک, بیمه سلامت 0 0 http://journal.ihio.gov.ir/browse.php?a_code=A-10-2390-1&slc_lang=fa&sid=1 Hossein Effat Panah حسین عفت پناه hoseineffatpanah@yahoo.com 10031947532846007049 10031947532846007049 No Daniel Sarlak دانیال سرلک dan.sarleak@gmail.com 10031947532846007050 10031947532846007050 No Anahita Bahmanjeh آناهیتا بهمنجه anahita.bahmanjeh@gmail.com 10031947532846007051 10031947532846007051 No Mohammad Javad Hossein Tehrani محمدجواد حسین تهرانی mjhosseintehrani@gmail.com 10031947532846007052 10031947532846007052 No rajab mardani رجب مردانی rajabmardani@yahoo.com 10031947532846007053 10031947532846007053 Yes