摘要
目的探讨人血清中附睾蛋白4(humanepididymis 4,HE4)、癌胚抗原(carcinoembryonic antigen,CEA)及内皮细胞特异性分子-1(endothelial cell specific molecule-1,ESM-1)三项检验指标在肺癌诊断中的价值。方法采用化学发光法检测50例肺癌患者(肺癌组)、50例肺部良性病变患者(良性组)血清中HE4、CEA水平,应用ELISA法检测ESM-1水平,分析比较2组三项指标水平差异,采用ROC曲线比较HE4、CEA及ESM-1单项与联合检测对肺癌的诊断性能。结果HE4、CEA、ESM-1的检测水平肺癌组明显高于良性组,差异均有统计学意义(Z=-2.292,P=0.022;Z=-5.412,P=0.000;Z=-6.431,P=0.000);ESM-1的ROC曲线下面积(0.983)>CEA(0.907)>HE4(0.672),结果表明在诊断肺癌中,ESM-1ROC面积最大,有较高的诊断意义;ESM-1水平在26.31 ng/ml时,诊断肺癌的敏感度为96.7%,特异度为96.7%;通过绘制ROC曲线发现AUC CEA+HE4+ESM-1=AUC CEA+ESM-1>AUC HE4+ESM-1>AUC CEA+HE4,通过Z检验分析,发现CEA+ESM-1联合检测与CEA+HE4+ESM-1检测的ROC曲线下面积均为0.997,无统计学意义(P>0.05),两者诊断效率相当。结论CEA和ESM-1对肺癌的诊断有较高应用价值,CEA+ESM-1联合检测可使肺癌在诊断效率上得到显著提高。
Objective To investigate the value of human epididymis protein 4(HE4),carcinoembryonic antigen(CEA)and endothelial cell specific molecule-1(ESM-1)in the diagnosis of lung cancer.Methods Serum levels of HE4 and CEA in 50 lung cancer patients(Lung Cancer Group)and 50 patients with benign lung lesions(benign group)were detected by chemiluminescence method.Serum levels of ESM-1 in them were detected by enzyme-linked immunosorbent assay(ELISA).Their serum levels were compared between groups.The diagnostic performance of a single detection of HE4,CEA and ESM-1,and their combination detection in lung cancer was compared by plotting the receiver operating characteristic(ROC)curves.Results Serum levels of HE4,CEA and ESM-1 in lung cancer group were significantly higher than those of benign group(Z=-2.292,P=0.022;Z=5.412,P=0.000;Z=6.431,P=0.000,respectively).The area under the curve(AUC)of ESM-1 in discriminating between lung cancer and benign lung lesions was the largest,followed by that of CEA and HE4(AUC=0.983,0.907 and 0.672,respectively).With the cut-off value of 26.31ng/ml,the sensitivity and specificity of ESM-1 in discriminating between lung cancer and benign lung lesions were 96.7%and 96.7%,respectively.The AUC of the combination detection of CEA+HE4+ESM-1 was the same highest as that of CEA+ESM-1(AUC=0.997,P>0.05),followed by that of HE4+ESM-1,and CEA+HE4.The diagnostic efficacy of the combination detection of CEA+HE4+ESM-1 was equal to that of CEA+ESM-1.Conclusion Serum CEA and ESM-1 have a high diagnostic potential in lung cancer,and their combination detection significantly enhances the diagnostic efficacy.
作者
霍丽静
侯慧卿
于芳
魏常梅
张玉敏
刘学欣
杨朝菊
王颖
HUO Lijing;HOU Huiqing;YU Fang(Hebei General Hospital,Hebei,Shijiazhuang 050051,China)
出处
《河北医药》
CAS
2023年第23期3591-3594,共4页
Hebei Medical Journal
基金
河北省医学科学研究重点课题(编号:20230269)
河北省医学科学研究重点课题计划(编号:20201538)
唐山市科学技术研究与发展计划项目创新团队(编号:19130202C)。
关键词
肺癌
人附睾蛋白4
癌胚抗原
内皮细胞特异性分子-1
lung cancer,human epididymis protein 4(HE4)
carcinoembryonic antigen(CEA)
endothelial cell specific molecule-1(ESM-1)
