三种血清肿瘤标志物联合肿瘤直径对原发性支气管肺癌的判别分析  

Discriminant analysis of three serum tumor markers combined with tumor diameter for primary bronchial lung cancer

作　　者：唐超[1] 韩可兴 TANG Chao;HAN Ke-xing(Bozhou People’s Hospital,Clinical College of Anhui Medical University,Bozhou,Anhui 236800,China)

机构地区：[1]安徽医科大学临床学院亳州市人民医院

出　　处：《临床肺科杂志》2020年第3期409-413,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的通过三种血清肿瘤标记物及肿瘤直径,对肺腺癌、肺鳞癌及小细胞肺癌性的病理分型进行判别分析。方法收集亳州市人民医院2012年5月至2019年5月经病理确诊为原发性支气管肺癌的住院及门诊患者216例,分别统计各肺癌病理类型,对纳入患者分别测定癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)、神经元特异性烯醇化酶(NSE)。纳入患者常规完善肺部256排螺旋CT扫描,利用本院读片软件对肿瘤长径、短径进行测量,并计算各患者肿瘤横截面面积。收集患者一般资料包括年龄、性别及年吸烟数量。利用判别分析模型,对各病理类型进行预判。结果小细胞肺癌与肺腺癌之间年龄存在统计学差异(P<0.05),三组间性别比存在统计学差异,卡方分割检验提示组内比较,均具有统计学差异(P<0.05),肺腺癌与肺鳞癌之间年吸烟量存在统计学差异(P<0.05)。三组间血清肿瘤标记物存在统计学差异,组间比较提示肺鳞癌与其他两组间CEA存在统计学差异(P<0.01)、肺鳞癌与肺腺癌间CYFRA21-1存在统计学差异(P<0.01)、小细胞肺癌与其他两组间NSE存在统计学差异(P<0.01)。三组间肿瘤长径、短径、横截面面积均无明显统计学差异(P>0.05)。经判别分析提示总体预判正确率为61.1%,其中肺腺癌、肺鳞癌、小细胞肺癌预判正确率分别为73.1%、55.4%、44.7%,Kappa相关系数为0.38,P<0.01,建立判别函数提示年龄、肿瘤标记物及肿瘤长径,判别相关系数较大。结论三种血清肿瘤标记物联合肿瘤长径,对原发性支气管肺癌病理类型具有一定的判别作用。Objective To analyze the pathological types of lung adenocarcinoma,lung squamous cell carcinoma and small cell lung cancer by three tumor markers and tumor diameters.Methods 216 inpatients and outpatients with primary bronchial lung cancer were collected from Bozhou people's Hospital from May 2012 to May 2019.The carcinoembryonic antigen(CEA),cytokeratin 19 fragment(CYFRA21-1)and neuron-specific enolase(NSE)were evaluated in the patients.The diameter needed to be measured and the cross-sectional area of each patient was calculated.Their general data were collected,including age,sex and annual smoking.Discriminant analysis model was utilized to predict the pathological types.Results There was a statistical difference in age between the age of small cell lung cancer and lung adenocarcinoma(P<0.05),and also between lung adenocarcinoma and lung squamous cell carcinoma of annual smoking(P<0.05).There was a statistical difference in sex ratio and partition of chi-square test among the three groups.There were significant differences in serum tumor markers among the three groups,including CEA in the lung squamous cell carcinoma group and the other two groups(P<0.01),CYFRA21-1 between lung squamous cell carcinoma and lung adenocarcinoma(P<0.01),and NSE between the small cell lung cancer group and the other two groups(P<0.01).There was no significant difference in tumor length,short diameter and cross-sectional area among the three groups(P>0.05).The results of discriminant analysis showed that the overall accuracy rate of prejudgment was 61.1%,among which the accuracy rates of lung adenocarcinoma,lung squamous cell carcinoma and small cell lung cancer were 73.1%,55.47%and 44.7%.The correlation coefficient of Kappa was 0.38%(P<0.01)and the correlation coefficient of tumor marker and tumor long diameter discrimi-nant was higher than that of tumor marker by establishing discriminant function. Conclusion The combination ofthree serum tumor markers and tumor length has a certain clinical discriminant effect on the pathological

关 键 词：肺癌 血清肿瘤标志物 瘤体大小 判别分析 

分 类 号：R734.2[医药卫生—肿瘤]