摘要
目的探讨肿瘤标志物癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、鳞状细胞癌抗原(SCC-Ag)、细胞角蛋白19片段抗原(CYFRA21-1)与D-二聚体(D-D)联合检测对非小细胞肺癌(NSCLC)的早期诊断价值。方法选取本院收治的60例NSCLC患者、60例良性肺病患者,以及同期接受健康体检的60例健康者作为研究对象。检测3组的血清CEA、NSE、SCC-Ag、CYFRA21-1及血浆D-D水平。对比3组的各指标检测水平及阳性率,分析各指标水平与病理类型的关系,以及各标志物单独检测与联合检测对NSCLC的诊断效能。结果肺癌组的CEA、NSE、SCC-Ag、CYFRA21-1、D-D水平均显著高于良性肺病组与对照组(P <0. 05)。良性肺病组的CEA、NSE、SCCAg、CYFRA21-1、D-D水平又显著高于对照组(P <0. 05)。肺癌组的CEA、NSE、SCC-Ag、CYFRA21-1、D-D阳性率分别为53. 3%、23. 3%、41. 7%、43. 3%、56. 7%,均明显高于对照组与良性肺病组(P <0. 05)。肺癌组中,腺癌患者的CEA水平显著高于鳞癌患者,SCC-Ag、CYFRA21-1、D-D水平均显著低于鳞癌患者(P <0. 05)。ROC曲线分析显示,5项联合检测的AUC值分别为0. 736、0. 771、0. 814、0. 755、0. 764、0. 915,明显比各项指标单独检测更高。5项联合检测对NSCLC的诊断敏感性、特异性、阳性预测值、阴性预测值分别为87. 3%、89. 6%、88. 5%、86. 5%,均显著高于各项单独检测(P <0. 05)。结论肿瘤标志物CEA、NSE、SCC-Ag、CYFRA21-1与D-D联合检测对NSCLC有较高的敏感性、特异性,能够有效提高NSCLC的早期诊断准确率。
Objective:To investigate the effect of tumor markers carcinoid antigen(CEA),neuron-specific enolase(NSE),squamous cell carcinoma antigen(SCC-Ag),cytokeratin 19 fragment antigen(CYFRA21-1)and D-dimer(D-D)in early diagnosis of non-small cell lung cancer(NSCLC).Methods:Sixty patients with NSCLC,60 patients with benign pulmonary disease,and Sixty healthy people who received physical examination at the same time were selected as subjects.The patients of three groups were detected in CEA,NSE,SCC-Ag,CYFRA21-1 and plasma D-D.The detection level and positive rate of each index were compared among the three groups,and the relationship was analyzed between each index level and pathological type.Results:The levels of CEA,NSE,SCC-Ag,CYFRA21-1 and D-D in lung cancer group were significantly higher than those in benign lung disease group and control group(P<0.05).The levels of CEA,NSE,SCCAg,CYFRA21-1 and D-D in the benign lung disease group were significantly higher than those in the control group(P<0.05).The positive rates of CEA,NSE,SCC-Ag,CYFRA21-1,D-D in lung cancer group respectively were 53.3%,23.3%,41.7%,43.3%and 56.7%,which were significantly higher than those in control group and benign lung disease group(P<0.05).In the lung cancer group,the CEA level of adenocarcinoma patients was significantly higher than that of squamous cell carcinoma patients,and the levels of SCC-Ag,CYFRA21-1 and D-D were significantly lower than those of squamous cell carcinoma patients(P<0.05).ROC curve analysis showed that the AUC values of the five combined tests respectively were 0.736,0.771,0.814,0.755,0.764 and 0.915,which were significantly higher than those of the individually detected indexes.The sensitivity,specificity,positive predictive value and negative predictive value of the five combined tests for NSCLC respectively were 87.3%,89.6%,88.5%and 86.5%,which were significantly higher than those of the individual tests(P<0.05).Conclusion:Combined detection of tumor markers CEA,NSE,SCC-Ag,CYFRA21-1 and D-D has high sensitivity and specificity for NSCLC,which can effectively improve the early diagnosis accuracy of NSCLC.
作者
刘奕
LIU Yi(Tianjin Chest Hospital,Tianjin 300350,China)
出处
《泰山医学院学报》
CAS
2019年第3期203-206,共4页
Journal of Taishan Medical College
