联合检测血清PCT和NSE对小细胞肺癌的诊断价值  

Diagnostic value of combination of PCT and NSE in serum for detecting small cell lung cancer

作　　者：张志强[1] 吴艳华[1] 王茂水[1] 王新锋[1] 汪运山[2] 

机构地区：[1]山东省胸科医院检验科,山东济南250013 [2]山东大学附属济南市中心医院中心实验室,山东济南250013

出　　处：《山东大学学报（医学版）》2016年第11期36-39,共4页Journal of Shandong University:Health Sciences

基　　金：山东省医药卫生科技发展计划(2015WS0207)

摘　　要：目的探讨联合检测血清降钙素原(PCT)和神经元特异性烯醇化酶(NSE)对小细胞肺癌的诊断价值。方法将123例排除肺部感染及其他感染史和肝脏等转移的新诊断的住院肺癌患者,分为鳞癌组(n=48)、腺癌组(n=52)与小细胞癌组(n=23),另选择门诊健康体检者作为对照组(n=40),比较各组之间PCT和NSE的水平。结果各组之间PCT和NSE水平相比,差异有统计学意义(P<0.01)。PCT在腺癌组、鳞癌组与小细胞癌组之间的差异有统计学意义(P<0.05),NSE在腺癌组、鳞癌组与小细胞癌组之间的差异有统计学意义(P<0.01)。PCT和NSE区分小细胞肺癌和鳞癌、腺癌的鉴别诊断最佳截断点分别为0.10和23.91 ng/m L,ROC曲线下面积分别为0.671和0.806,敏感性为56.5%和69.6%,特异性为77.0%和90.0%,联合检测(PCT+NSE)可将特异性提高为98.0%,联合检测(PCT或NSE)可将敏感性提高为82.6%。结论检测血清PCT对小细胞肺癌具有一定的鉴别意义,在小细胞肺癌患者中判断细菌感染时,应谨慎判读PCT结果。联合检测PCT和NSE将有助于肺癌的鉴别诊断和组织分型。Objective To investigate the diagnostic value of combination of procalcitonin（PCT） and neuron-specific enolase（NSE） in serum for differentiating small cell lung cancer from other lung cancers. Methods A total of 123 lung cancer patients without lung infections,other sites infection history and liver metastasis were divided into three groups： squamous carcinoma group（n = 48）,adenocarcinoma group（n = 52） and small cell carcinoma group（n =23）. And 40 healthy volunteers were taken as control group. Serum PCT and NSE levels were tested and compared among each group. Results Serum PCT and NSE levels were statistical different among the four groups（P 〈 0. 01）.Mann-Whitney analysis showed that,there were statistical differences between small cell carcinoma and squamous carcinoma or adenocarcinoma groups（P 〈 0. 05,P 〈 0. 01）. For PCT and NSE,the area under the ROC curve was 0. 671 and 0. 806,the best cut-off point was 0. 10 and 23. 91 ng / m L,sensitivity was 56. 5% and 69. 6%,and specificity was77. 0% and 90. 0%. Combination（PCT ＋ NSE） would increase the specificity to 98. 0%,while combination（PCT orNSE） would increase the sensitivity to 82. 6%. Conclusion PCT can be used as a marker in differentiating small cell lung cancer from other lung cancers. However,for the small cell lung cancer patients,serum PCT cannot be simply used to detect the infection. Meanwhile,combined biomarkers（PCT and NSE） will improve the diagnostic performance in discrimination of small cell lung cancer.

关 键 词：降钙素原 神经元特异性烯醇化酶 小细胞肺癌 ROC曲线 

分 类 号：R734.2[医药卫生—肿瘤]