肿瘤标志物联合检测诊断肺癌的临床价值  

Clinical value of combined detection of tumor markers in diagnosis of lung cancer

作　　者：俞欢欢 刘玉薇 万楠[1] YU Huan-huan;LIU Yu-wei;WAN Nan(Laboratory of The General Hospital of Shenyang Military,Shenyang 110016,China)

机构地区：[1]沈阳军区总医院检验医学中心,辽宁沈阳110016

出　　处：《中国实验诊断学》2018年第11期1928-1931,共4页Chinese Journal of Laboratory Diagnosis

基　　金：辽宁省自然科学基金;循环MicroRNA作为新型冠心病血浆标志物的相关研究(201602792)

摘　　要：目的验证癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、细胞角蛋白21-1(CYFRA21-1)单独应用在肺癌中的诊断价值并探讨三种肿瘤标志物联合检测是否为诊断肺癌的一个更准确的方法。方法选取2017年1月—2018年3月于我院住院、怀疑诊断为肺癌的119例患者,根据CT及病理结果,其中62例患者排除了肺癌设为对照组,57例患者诊断为肺癌设为观察组,利用迈瑞CL2000I化学发光免疫分析仪检测CEA,NSE,CYFRA21-1,计算3种指标单独及联合应用的灵敏度、特异性,绘制ROC曲线,分析其各自诊断效能。结果研究表明观察组患者CEA,NSE,CYFRA21-1水平(3.15(0.29-194.25)ng/ml,12.63(3.51-351.90)ng/ml,3.70(0.68-700.21)ng/ml)明显高于对照组(2.14(0.1-12.03)ng/ml,10.69(5.34-108.45)ng/ml,2.28(0.64-10.59)ng/ml),差异均有统计学意义(P<0.05)。灵敏度最高的为CYFRA21-1,其灵敏度为51.64%;特异性最高的为CEA,其特异性为90.32%;而3项联合指标检测的灵敏度较高为71.93%;特异度相对较低为62.90%。3种指标联合分析ROC曲线下面积(AUC)为0.738,明显大于各指标单独应用的AUC。结论三种血清肿瘤标志物的联合检测能提高肺癌的检出率。Objective To verify the diagnostic value of carcinoembryonic antigen（CEA）,neuron specific enolase（NSE）and cytokeratin 21-1（CYFRA21-1）in lung cancer and explore three tumor markers Joint testing is a more accurate method for diagnosing lung cancer.Methods A total of 119 patients admitted to our hospital from January 2017 to March 2018 were selected.According to CT and pathological results,62 patients were excluded from the establishment of lung cancer as a control group and 57 patients were diagnosed with lung cancer.Established as an observation group,the use of Mindray CL2000 Ichemiluminescence immunoassay analyzer for quantitative determination of CEA,NSE,CYFRA21-1,calculate the sensitivity and specificity of three indicators used alone and in combination,draw ROC curve,analyze their respective diagnostic efficacy.Results The study showed that the CEA,NSE and CYFRA21-1 levels（3.15（0.29-194.25）ng/ml,12.63（3.51-351.90）ng/ml,and 3.70（0.68-700.21）ng/ml）were significantly higher in the observation group than in the control group.There were significant differences between the groups（2.14（0.1-12.03）ng/ml,10.69（5.34-108.45）ng/ml,and 2.28（0.64-10.59）ng/ml）（P〈0.05）.The highest sensitivity is CYFRA21-1 with a sensitivity of 51.64%.The highest specificity was CEA,and its specificity was 90.32%.The sensitivity of the three combined indicators was 71.93% and the specificity was 62.90%.The area under the ROC curve（AUC）for the combined analysis of the three indicators was 0.738,which was significantly greater than the AUC for the three single use cases.Conclusion The combined detection of three serum tumor markers is more accurate and sensitive than lung cancer alone.

关 键 词：肺癌 CEA NSE CYFRA21-1 

分 类 号：R734.2[医药卫生—肿瘤]