摘要
目的分析癌胚抗原(CEA)、糖类癌抗原125(CA125)、神经元特异性烯醇化酶(NSE)及细胞角蛋白-19片段抗原(CYFRA21-1)等多种肿瘤标志物联合诊断肺癌的应用价值。方法选择2013年9月—2016年9月山东省济宁市兖矿集团总医院呼吸内科接受治疗的肺癌患者200例(肺癌组)、肺部良性病变患者200例(良性病变组)及同期健康体检者50例(健康对照组)作为研究对象。对3组研究对象血清肿瘤标志物CEA、CA125、NSE及CYFRA21-1水平进行测定,分析各指标单独及联合诊断肺癌的价值。结果肺癌组患者的血清CEA、CA125、NSE及CYFRA21-1水平>肺部良性病变组患者>健康对照组(F=733.100、307.600、95.240、481.000,P均=0.000);血清CEA、CA125腺癌患者最高,血清NSE小细胞肺癌患者最高,血清CYFRA21-1鳞癌患者最高(F=5.181、7.326、11.138、23.336,P=0.006、0.001、0.000、0.000);血清CEA、CA125、NSE及CYFRA21-1水平在Ⅲ~Ⅳ期肺癌患者高于Ⅰ~Ⅱ期肺癌患者(F=12.675、8.263、4.865、7.833;P均=0.000);ROC曲线下面积(AUC)值从大到小依次为:4指标联合诊断>CEA>CYFRA21-1>CA125>NSE;4指标联合诊断肺癌最佳cut-off值为9.967,此时敏感度为88.5%,特异度为90.0%,约登指数(Youden index)为0.785。结论 CEA、CA125、NSE及CYFRA21-1在肺癌患者的诊断及临床分期判断中有着一定的应用价值,并且联合检测能够有效提高肺癌诊断的准确率,有助于肺癌筛查工作的有效开展,具有重要的临床意义。
Objective To analyze and investigate the value of muhiple tumor markers in the diagnosis of lung cancer. Methods Two hundred cases of patients with lung cancer, 200 cases of patients with benign pulmonary disease and 50 cases of healthy volunteers were selected, which were treated in hospital from September 2013 to September 2016. The serum tumor markers CEA, CA125, NSE and CYFRA21-1 levels were measured, and the values of individual and combined diagnoses of lung cancer were analyzed. Results In the terms of serum CEA, CA125, NSE and CYFRA21-1, the patients with lung cancer were significantly higher than those of patients with benign pulmonary disease and healthy volunteers （ F = 733. 100, F = 307.6, F = 95. 240, F = 481. 000; P = 0.000, P = 0.000, P = 0.000, P = 0. 000） ; In the serum CEA, CA125, adenocarci- noma group was significantly higher than other types,in serum NSE, small cell lung cancer group was significantly higher than other types, in serum CYFRA21-1, squamous cell carcinoma group was significantly higher than that in other types （ F = 5. 181,F=7.326,F=11. 138, F=23.336; P= 0.006, P= 0.001, P= 0.000, P= 0.000）;The serum CEA, CA125, NSE and CYFRA21-1 levels of the patients with Ⅲ-Ⅳ stage lung cancer were significantly higher than those of patients with-Ⅱ stage lung cancer （F= 12.675, F=8. 263, F =4. 865, F =7. 833; P = 0. 000, P =0. 000, P =0. 000, P =0. 000） ; The ROC curve showed that the best cutoff value for diagnosis of lung cancer by combination of four indicators was 9. 967, the sensitivity was 88.5%, the specificity was 90.0%, and the Youden index was 0. 785. Conclusion Serum CEA, CA125, NSE and CYFRA21-1 have certain application value in the diagnosis and clinical stage judgment of lung cancer, and combination of these indices can effectively improve the accuracy of lung cancer diagnosis, which is contribute to the effective development of lung cancer screening, has an important clinical significance.
出处
《疑难病杂志》
CAS
2018年第1期18-21,共4页
Chinese Journal of Difficult and Complicated Cases
