摘要
目的探讨血清神经元特异性烯醇化酶(neuron specific enolase,NSE)、糖类抗原(carbohydrate antigen,CA)125、癌胚抗原(carcinoembryonic antigen,CEA)、非小细胞肺癌抗原(cytokeratin 19fragment,CYFRA21-1)联合检测对小细胞肺癌(small cell lung cancer,SCLC)的诊断价值。方法 SCLC患者51例(SCLC组)和同期体检健康者25例(对照组),采用电化学发光法检测2组血清NSE、CA125、CEA、CYFRA21-1、CA19-9、CA72-4水平,应用ROC曲线进行分析和评价。结果 SCLC组NSE[(60.22±19.62)μg/L]、CA125[(49.79±9.78)u/mL]、CEA[(6.46±1.02)μg/L]、CYFRA21-1[(3.95±0.85)μg/L]高于对照组[(13.47±4.41)μg/L、(11.49±3.32)u/mL、(1.93±0.75)μg/L、(2.14±0.64)μg/L],差异有统计学意义(P<0.01),SCLC组CA19-9[(15.28±4.39)u/mL]、CA72-4[(2.89±0.36)u/mL]与对照组[(8.42±1.03)u/mL、(1.82±0.41)u/mL]比较差异无统计学意义(P>0.05);血清NSE、CA125、CEA、CYFRA21-1在SCLC组的AUC分别为0.905、0.853、0.778、0.705;ROC曲线分析显示NSE、CA125、CEA、CYFRA21-1的临床诊断临界点分别为23.23μg/L、19.71 u/mL、2.64μg/L、3.24μg/L,单项检测时,NSE、CA125、CEA、CYFRA21-1的灵敏性分别为74.51%、64.71%、64.71%、50.98%,特异性分别为100.00%、96.00%、88.00%、92.00%,4项指标联合检测时灵敏性为94.12%,特异性为84.00%。结论血清NSE是诊断SCLC的一个较理想指标;检测血清NSE、CA125、CEA、CYFRA21-1水平对诊断SCLC有重要意义,4项联合检测灵敏度较单项检测升高,但特异性下降。
Objective To evaluate the value of combined detection of neuron specific enolase （NSE）, carbohydrate antigen （CA） 125, carcinoembryonic antigen （CEA） and cytokeratin 19 fragment （CYFRA21-1） to the diagnosis of small cell lung cancer （SCLC）. Methods The levels of serum NSE, CA125, CEA, CYFRA21-1, CA19-9 and CA72-4 were detected in patients with SCLC （SCLC group） and 25 healthy volunteers （control group）. ROC curve was adopted to analyze and evaluate the results. Results The levels of NSE （（60.22±19.62） μg/L）, CA125 （（49.79±9.78） u/mL）, CEA （（6.46±1.02） μg/L） and CYFRA21-1 （（3.95±0.85）μg/L） in SCLC group were significantly higher than those in control group （（13.47±4.41） /μg/L, （11.49±3.32） u/mL, （1.93±0.75） μg/L, （2.14±0.64） μg/L） （P〈0.01）. There were no significant differences in the levels of CA19 9 and CA72-4 between SCLC group （（15.28±4.39） u/mL, （2.89±-0.36） u/mL） and control group （（8.42±1.03）, （1.82±0.41） u/mL） （P〈0. 05）. AUC values of serum NSE, CA125, CEA and CYFRA21-1 were 0. 905, 0. 853, 0. 778 and 0. 705 respectively in SCLC group. The clinical diagnostic cut-of points of NSE, CA125, CEA and CYFRA21-1 were 23.23 μg/L, 19.71 u/mL, 2.64μg/L and 3.24 μg/L. The sensitivities of serum NSE, CA125, CEA and CYFRA21-1 were 74. 51%, 64. 71%, 64. 71% and 50. 98% and the specificities were 100. 00%, 96.00%, 88. 00% and 92.00%. The sensitivity and specificity of combined detection of NSE, CA125, CEA and CYFRA21-1 were 94.12% and 84.00%. Conehlsion Serum NSE level is an ideal indicator fordiagnosing SCLC. The single detection of serum NSE, CA125, CEA and CYFRA21-1 has an important significance in diagnosing SCLC. The combined detection of them four has higher sensitivity and lower specificity than the detection of each single one.
出处
《中华实用诊断与治疗杂志》
2016年第10期1005-1007,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
国家自然科学基金(81473497)
