4项血清肿瘤标志物联合检测在肺癌中的应用价值分析  

The value of combined detection of 4 serum tumor markers in lung cancer

作　　者：单新洁[1] 祁晓婷[2] 俞荣[1] 王丽[1] SHAN Xin-jie;QI Xiao-ting;YU Rong;WANG Li(Department of North Hospital Clinical Laboratory,Xinjiang Uygur Autonomous Region People′s Hospital,Urumqi 830054,China;The Center of Clinical Laboratory,Xinjiang Uygur Autonomous Region People′s Hospital,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院北院检验科,新疆乌鲁木齐830054 [2]新疆维吾尔自治区人民医院临检中心,新疆乌鲁木齐830001

出　　处：《河北医科大学学报》2018年第7期833-837,共5页Journal of Hebei Medical University

基　　金：国家重点基础研究发展计划(2012CB722414)

摘　　要：目的评价血清胃泌素释放肽前体(progastrin-releasing peptide,ProGRP)、鳞状上皮细胞癌抗原(squamous cell carcinoma antigen,SCC-Ag)、细胞角蛋白19片段抗原(cytokerantin 19fragment,Cyfra21-1)及癌胚抗原(carcino-embryonic antigen,CEA)4项肿瘤标志物联合诊断肺癌的价值。方法随机抽取肺癌患者71例、肺部良性疾病106例和健康体检者214例,采集3组受试者的肘正中静脉血样,采用酶联免疫吸附测定法检测4项肿瘤标志物水平。比较3组受试者4项肿瘤标志物的水平、阳性率和阳性指标数,并比较4项肿瘤标志物单独和联合诊断肺癌的诊断效能(灵敏度、特异度、准确度、阳性预测值和阴性预测值)。结果肺癌组血清ProGRP、SCCAg、Cyfra21-1和CEA水平、阳性率和阳性指标数均显著高于健康对照组和良性疾病组(P<0.05)。ROC曲线显示,4项肿瘤标志物单独诊断肺癌时,ProGRP的AUC最大(AUC=0.898),CEA(AUC=0.873)和Cyfra21-1(AUC=0.813)次之,SCC-Ag最低(AUC=0.798);4项标志物联合诊断后AUC得到了显著提高(AUC=0.975);约登指数得出的最佳截点为ProGRP>47.5ng/L、SCC-Ag>2.12μg/L、Cyfra21-1>3.41μg/L和CEA>5.98μg/L。4项肿瘤标志物联合诊断的准确度、灵敏度、特异度、阳性预测值和阴性预测值均显著高于单独诊断。结论应用ProGRP、SCC-Ag、Cyfra21-1及CEA联合诊断肺癌具有较高的诊断效能。Objective To evaluate the value of progastrin-releasing peptide（ProGRP）, Squamous cell carcinoma antigen（SCC-Ag）, Cytokeratin 19 fragment antigen（Cyfra21-1） and carcino-embryonic antigen（CEA） of 4 tumor markers in combined diagnosis of lung cancer.Methods The 71 cases of lung cancer, 106 cases of benign lung diseases and 214 cases of healthy subjects were randomly selected. The median blood samples from the elbow of 3 groups were collected and the levels of 4 tumor markers were detected by enzyme-linked immunosorbent assay. The level of 4 tumor markers, the positive rate and the number of positive indicators in the 3 groups were compared. The diagnostic efficiency（sensitivity, specificity, accuracy, positive predictive value and negative predictive value） of 4 tumor markers alone and combined in the diagnosis of lung cancer were compared.Results The levels of serum ProGRP, SCC-Ag, Cyfra21-1 and CEA, positive rate and positive index in lung cancer group were significantly higher than those in healthy control group and benign disease group（ P 〈 0.05）. The ROC curve showed that when 4 tumor markers were diagnosed separately for lung cancer, AUC of ProGRP was the largest（AUC= 0.898 ）, CEA（AUC= 0.873 ） and Cyfra21-1（AUC= 0.813 ） were less, and SCC-Ag（AUC= 0.798 ） were the lowest. The AUC of the 4 markers was increased significantly after combined diagnosis（AUC= 0.975 ）. The best cut-off point Youden index is derived ProGRP〉 47.5 ng/L, SCC-Ag〉 2.12 g/L, Cyfra21-1〉 3.41 g/L and CEA〉 5.98 g/L. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of 4 tumor markers combined diagnosis were significantly higher than those of separate diagnosis.Conclusion The combined diagnosis of lung cancer with ProGRP, SCC-Ag, Cyfra21-1 and CEA has high diagnostic efficiency.

关 键 词：肺肿瘤 肿瘤标记 生物学 诊断 

分 类 号：R735.7[医药卫生—肿瘤]