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作 者:张亚娟[1,2] 张健鹏[1] 常德[1] 宋瑞珍 ZHANG Yajuan;ZHANG Jianpeng;CHANG De;SONG Ruizhen(Department of Respiratory Medicine, General Hospital of Chinese People's Armed Police Force, Beijing 100039, China;Specialty of Clinical Internal Medicine, Jinzhou Medical University, Jinzhou 121001, China)
机构地区:[1]武警总医院呼吸内科,北京100039 [2]辽宁省锦州医科大学,121001
出 处:《中华灾害救援医学》2017年第3期138-142,共5页Chinese Journal of Disaster Medicine
摘 要:目的探讨孤立性肺结节(solitary pulmonary nodule,SPN)患者血清肿瘤标志物、凝血指标在SPN良恶性诊断中的价值。方法回顾性分析明确病理诊断的肺结节患者108例,搜集整理患者的临床资料,包括血清肿瘤标志物[癌胚抗原(carcino embryonic antigen,CEA),神经元特异性烯醇化酶(neuron-specific enolase,NSE),细胞角蛋白19片段(cytokerantin-19-fagment,CYFRA21-1),癌抗原72-4(cancer antigen72-4,CA72-4),鳞状细胞癌抗原(squamouscellcarcinomaantigen,SCC),癌抗原125(cancer antigen 125,CA125)];凝血指标[纤维蛋白原浓度(fibrinogen concentration,Fbg-C),凝血酶原时间(prothrombintime,PT),活化部分凝血活酶时间(activatedpartialthromboplastintime,APTT),凝血酶时间(thrombintime,TT)],分析其与肺结节病变性质的关系。结果CEA、NSE表达水平,恶性肺结节高于良性肺结节,且差异有统计学意义(Z=-2.595,P=0.009;Z=-2.389,P=0.017);Fbg-C表达水平,恶性肺结节高于良性肺结节,且差异有统计学意义(t=3.385,P=0.001);CEA、Fbg-C在取最佳截断值时灵敏度同为42.86%。结论当CEA的取值为3.9 ng/ml,Fbg-C取值为332 mg/dl时,单一和联合检测灵敏度均有所提高,对肺结节良恶性的判断均有重要的临床价值。Objective This study objective was to investigate the relationship between serum tumor markers and serum fibrinogen levels in patients with solitary pulmonary nodules (SPN). Methods A retrospective analysis was conducted on 108 patients with pulmonary nodules confirmed by pathological diagnosis, all the patients' clinical data including serum tumor markers [carcino embryonic antigen (CEA), neuron-specific enolase (NSE), cytokerantin-19-fragment (CYFRA21-1), cancer antigen 72-4 (CA72-4), squamous cell carcinoma antigen (SCC), cancer antigen 125 (CA125)] and blood coagulation indexes [fibrinogen concentration (Fbg-C), prothrombin time (PT), activated partial thromboplastin time (APTT),thrombin time (TT)] were collected, and their relationship with the nature of pulmonary nodules lesions were analysed. Results Theexpression levels of CEA, NSE in malignant lung nodules were higher than in the benign pulmonary nodules (Z=-2.595, P=0.009;Z=-2.389,P=0.017) and the expression level of Fbg-C was higher than in the benign pulmonary nodules (t=3.385,P=0.001). The sensitivity of CEA and Fbg-C was 42.86% when the best cut-off value was obtained. Conclusions When the cut off value of CEA and Fbg-C is 3.9 ng/ml and 332 mg/dl respectively, the sensitivity was improved by both single and joint detection, which has an important clinical value in the diagnosis of benign and malignant pulmonary nodules.
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