肿瘤标志物SCC-Ag、CEA、CYFRA21-1和D-二聚体联合检测对非小细胞肺癌的早期诊断价值  

Value of combined detection of tumor markers SCC-Ag,CEA,CYFRA21-1 and D-dimer in early diagnosis of non-small cell lung cancer

作　　者：孙洪帅 朱华[1] 高海燕[1] 万广财 于秀艳[1] SUN Hongshuai;ZHU Hua;GAO Haiyan;WAN Guangcai;YU Xiuyan(Department of Clinical Laboratory,Jilin Provincial Tumor Hospital,Changchun 130012,China)

机构地区：[1]吉林省肿瘤医院检验科,吉林长春130012

出　　处：《吉林大学学报（医学版）》2018年第5期1020-1024,共5页Journal of Jilin University：Medicine Edition

基　　金：国家高技术研究发展计划(863计划)项目资助课题(2011AA02A111)

摘　　要：目的:探讨肿瘤标志物鳞状细胞癌抗原(SCC-Ag)、癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)和D-二聚体(D-D)在非小细胞肺癌(NSCLC)患者体内的表达水平,阐明其对NSCLC早期诊断的临床价值。方法:选取NSCLC患者200例(NSCLC组)、肺部良性病变患者198例(肺部良性病变组)和健康体检者196名(对照组)作为研究对象,检测静脉血血清中SCC-Ag、CEA、CYERA21-1和D-D水平,并进行组间比较。绘制受试者工作特征曲线(ROC曲线)分析各肿瘤标志物、D-D水平以及联合指标在NSCLC患者中的诊断价值。结果:NSCLC组患者各肿瘤标志物及D-D水平均明显高于肺部良性病变组和对照组(P<0.01);肺腺癌患者CEA水平高于肺鳞癌患者(P=0.005),肺鳞癌患者SCC-Ag和CYFRA21-1水平高于肺腺癌患者(P=0.008,P=0.004);Ⅲ-Ⅳ期NSCLC患者CEA、CYFRA21-1和D-D水平明显高于Ⅰ-Ⅱ期NSCLC患者(P<0.05)。ROC曲线,单项检测中,SCC-Ag的曲线下面积(AUC)最大(AUC=0.805),其灵敏度和特异度分别为85.42%和64.21%,联合指标的诊断效能优于各单项指标(AUC=0.933),其灵敏度和特异度分别为86.46%和88.42%。结论:肿瘤标志物SCC-Ag、CEA、CYFRA21-1和D-D联合检测可明显提高NSCLC早期诊断的灵敏度和特异度,其对NSCLC早期诊断具有重要意义。Objective:To investigate the expression levels of tumor markers squamous cell carcinoma antigen(SCC-Ag),carcinoembryonic antigen(CEA),cytokeratin 19 fragment(CYFRA21-1)and D-dimer(D-D)of the patients with non-small cell lung cancer(NSCLC),and to elucidate its clinical value in the early diagnosis of NSCLC.Methods:A total of 200 patients with NSCLC(NSCLC group),198 patients with benign lung disease(benign lung disease group)and 196 healthy subjects(control group)were selected and the levels of tumor markers and D-D were detected and compared between groups.The receiver operator characteristic curve(ROC)was drawn to analyze the diagnostic values of different tumor markers,D-D,and joint indicators in the patients with NSCLC.Results:The levels of tumor markers and D-D of the patients in NSCLC group were significantly higher than those in benign lung disease group and control group(P<0.01).The level of CEA in lung adenocarcinoma was higher than that in lung squamous cell carcinoma(P=0.005).The levels of SCC-Ag and CYFRA21-1 in lung squamous cell carcinoma were higher than those in lung adenocarcinoma(P=0.008,P=0.004).The levels of tumor markers CEA,CYFRA21-1 and D-D of the patients with stageⅢandⅣNSCLC were significantly higher than those of the patients with stageⅠandⅡNSCLC(P<0.05).The ROC curves showed that area under curve(AUC)of SCC-Ag was higher than other single indexes(AUC=0.805);the sensitivity and specificity were 85.42%and 64.21%,respectively.The diagnostic efficacy of the joint indicators was better than that of each single index(AUC=0.933);the sensitivity and specificity were 86.46%and 88.42%,respectively.Conclusion:Combined detection of tumor markers SCC-Ag,CEA,CYFRA21-1 and D-D can significantly increase the sensitivity and specificity of early diagnosis of NSCLC and has important significance in the early diagnosis of NSCLC.

关 键 词：癌 非小细胞肺 肿瘤标志物 D-二聚体 受试者工作特征曲线 

分 类 号：R331[医药卫生—人体生理学] R734.2[医药卫生—基础医学]