支气管内超声结合引导鞘联合针吸术及血清因子对肺癌的诊断价值  

Diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration combined with serum factors for lung cancer

作　　者：刘岩[1] 刘勇[1] 孙如坤[1] 李广 LIU Yan;LIU Yong;SUN Rukun;LI Guang(Department of Respiratory and Critical Care Medicine,Zhoukou Central Hospital,Zhoukou 466000,He’nan,China)

机构地区：[1]周口市中心医院呼吸与危重症医学科,河南周口4660000

出　　处：《癌症进展》2020年第20期2099-2101,2129,共4页Oncology Progress

摘　　要：目的探讨支气管内超声结合引导鞘联合针吸术(EBUS-GS-TBNA)及血清因子对肺癌的诊断价值。方法选取120例肺部病变患者,所有患者均接受了EBUS-GS-TBNA检查及血清细胞角质蛋白19片段抗原21-1(CYFRA21-1)和恶性肿瘤特异度生长因子(TSGF)水平检测。以病理学检查结果为金标准,采用受试者工作特征(ROC)曲线和曲线下面积(AUC)分析EBUS-GS-TBNA联合血清CYFRA21-1和TSGF对肺癌的诊断效能。结果120例肺部疾病患者中,最终确诊肺癌患者108例和非肺癌患者12例。肺癌患者血清中的CYFRA21-1、TSGF水平分别高于非肺癌患者(P<0.05)。EBUS-GS-TBNA诊断肺癌的灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为90.74%(98/108)、100%(12/12)、91.67%(98/120)、100%(98/98)和54.55%(12/22)。血清CYFRA21-1、TSGF诊断肺癌的灵敏度分别为74.50%和73.00%,特异度分别为72.20%和70.00%。EBUS-GS-TBNA联合CYFRA21-1、TSGF诊断肺癌的灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为98.15%(106/108)、100%(12/12)、98.33%(118/120)、100%(106/106)和85.71%(12/14)。结论CYFRA21-1、TSGF在肺癌患者血清中的表达水平较高,EBUS-GS-TBNA联合CYFRA21-1、TSGF在肺癌的辅助诊断中具有较好的应用价值。Objective To investigate the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration(EBUS-GS-TBNA)through a guide sheath combined with serum factors for lung cancer.Method A total of 120 patients with lung disease were enrolled and selected.The subjects were given EBUS-GS-TBNA examination,serum cyto-keratin 19 fragment antigen 21-1(CYFRA21-1)and tumor specific growth factor(TSGF)were detected.Pathological examination results was set as the gold standard,receiver operating characteristic(ROC)curve and area under the curve(AUC)were used to analyze the diagnostic efficacy of EBUS-GS-TBNA combined with serum CYFRA21-1 and TSGF for lung cancer.Result Among the 120 patients,108 were finally diagnosed as lung cancer while 12 were not.The serum levels of CYFRA21-1 and TSGF in lung cancer patients were higher than those in non-lung cancer patients(P<0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of EBUS-GS-TBNA in the diagnosis of lung cancer were 90.74%(98/108),100%(12/12),91.67%(98/120),100%(98/98)and 54.55%(12/22),respectively.The sensitivity of serum CYFRA21-1 and TSGF in diagnosing lung cancer were 74.50% and 73.00%,and the specificity was 72.20% and 70.00%,respectively.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of EBUS-GS-TBNA combined with CYFRA21-1 and TSGF in the diagnosis of lung cancer were 98.15%(106/108),100%(12/12),98.33%(118/120),100%(106/106)and 85.71%(12/14),respectively.Conclusion The expression level of CYFRA21-1 and TSGF in the serum of lung cancer patients is relatively high,indicating that EBUS-GS-TBNA combined with CYFRA21-1 and TSGF shows promising application value in the auxiliary diagnosis of lung cancer.

关 键 词：支气管内超声结合引导鞘联合针吸术 细胞角质蛋白19片段抗原21-1 恶性肿瘤特异度生长因子 肺癌 诊断价值 

分 类 号：R734.2[医药卫生—肿瘤]