摘要
目的:探讨纤维支气管镜(FB)检查联合血清肿瘤标志物(TM)检测对肺癌的诊断价值。方法:回顾性收集简阳市人民医院2014年1月至2016年12月期间进行纤维支气管镜检查的258例肺病患者,采用化学发光免疫分析法对患者清晨空腹静脉血分离血清进行癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原199(CA19-9)、细胞角蛋白19片段21-1(CYFRA21-1)四种肿瘤标志物的含量水平进行检测。以病理诊断作为金标准,计算FB检查、TM检测及两者联合诊断的准确率、灵敏度、特异度等指标。结果:肺癌组患者FB检查阳性率及TM检测各指标阳性率均高于肺部良性疾病组(P<0.05)。III期+IV期患者FB检查和CA125检测的阳性率均高于I期+II期患者(P<0.05)。肺癌患者的肿瘤标志物CEA、CA125、CA19-9、CYFRA21-1水平均显著高于肺部良性疾病组(均P<0.05)。联合检测中,四种TM联合检测的灵敏度、特异度、阴性预测价值均较高,均高于单项TM指标;FB+TM联合检测的灵敏度、特异度、阴性预测价值均显著高于FB单独检测和4种TM联合检测结果。结论:单使用FB检查或TM单一指标检测对于肺癌和肺部良性病变的诊断有局限性,将FB检查或TM检测相结合,肺癌的早期诊断效能将得到提升。
Objective： To explore the diagnostic value of fiberoptic bronchoscopy（ FB） test combined with tumor marker（ TM） test in patients with lung cancer. Methods： 258 patients with lung disease who underwent FB from January2014 to December 2016 in The People＇s Hospital of Jianyang City were collected. The levels of carcinombryonic antigen（ CEA）,cancer antigen125（ CA125）,cancer antigen 199（ CA199） and cytokerantin 19 fragment（ CYFRA21-1） in serum of 258 patients with lung disease were detected by electrochemiluminescent. The diagnostic accuracy,sensitivity,specificity and other indexes were calculated by using pathological diagnosis as the gold standard,and the diagnostic accuracy,sensitivity and specificity of FB test and TM test were calculated. Results： The positive rate of FB test and the positive rate of TM test in lung cancer group were higher than those in lung benign disease group（ P 〈 0. 05）. The positive rates of FB test and CA125 in patients with stage III and ＋ IV were higher than those in stage ＋ II and I（ P 〈 0. 05）. The tumor markers CEA,CA125,CA19-9 and CYFRA21-1 levels in lung cancer patients were significantly higher than those in the lung benign diseases group（ P 〈 0. 05）. Detection sensitivity,specificity and negative predictive value of four TM tests were were higher than those of single TM test; sensitivity,specificity,negative predictive value of combined detection of FB＋ TM were significantly higher than those of FB test alone and 4 TM tests. Conclusion： The use of either FB test or TM test alone is not acceptable in the diagnosis of lung cancer and lung benign lesions. FB test combined with TM test is acceptable in the early diagnoses of lung cancer.
作者
刘益民
赖永才
贾坤林
徐翠容
陈忠军
Liu Yimin;Lai Yongcai;Jia Kunlin;Xu Cuirong;Chen Zhongjun(Department of Respiratory, The People＇ s Hospital of Jianyang City, Jianyang 641400, Sichuan, China)
出处
《肿瘤预防与治疗》
2018年第3期189-192,共4页
Journal of Cancer Control And Treatment
关键词
肺肿瘤
纤维支气管镜
肿瘤标志物
Lung cancer
Fiberoptic bronchoscopy
Tumor markers
