CA199、NSE、CA153、CEA联合检测在脑胶质瘤诊断及预后分析中的应用  

Application of combined detection of CA199,NSE,CA153 and CEA in diagnosis and prognosis analysis of brain glioma

作　　者：张敏 牛发良[1] 赵东霞 ZHANG Min;NIU Faliang;ZHAO Dongxia(Department of Nuclear Medicine,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院核医学科,河北张家口075000

出　　处：《国际检验医学杂志》2021年第3期288-292,共5页International Journal of Laboratory Medicine

基　　金：河北省医学科学研究课题(20191653)。

摘　　要：目的探讨糖类抗原(CA)199、神经元特异性烯醇化酶(NSE)、CA153、癌胚抗原(CEA)在脑胶质瘤中的诊断价值及其与预后的关系。方法收集该院2017年8月至2019年9月收治的52例脑胶质瘤患者为脑胶质瘤组,另选取60例脑外伤颅内压手术患者为对照组。采用酶联免疫吸附试验法检测CA199、NSE、CA153、CEA水平,采用受试者工作特征曲线评估CA199、NSE、CA153、CEA对脑胶质瘤的诊断价值,对比4项指标联合检测与单项检测的诊断效能。采用Logistic回归分析CA199、NSE、CA153、CEA与患者预后的关系。结果脑胶质瘤组患者血清CA199、NSE、CA153、CEA水平均较对照组高,差异有统计学意义(P<0.05);与低级别脑胶质瘤患者相比,高级别脑胶质瘤患者的血清CA199、NSE、CA153、CEA水平均升高,差异有统计学意义(P<0.05)。NSE、CA199、CA153、CEA单项检测诊断脑胶质瘤的曲线下面积分别为0.709(95%CI:0.616~0.791)、0.859(95%CI:0.781~0.918)、0.782(95%CI:0.694~0.854)、0.630(95%CI:0.694~0.854)。NSE、CA199、CA153、CEA联合检测诊断脑胶质瘤的灵敏度为88.46%,特异度为81.67%,准确度为84.82%,4项指标联合诊断灵敏度、准确度均显著高于单项检测,差异有统计学意义(P<0.05)。与预后良好组相比,预后不良组患者血清中CA199、NSE、CA153、CEA水平均显著升高,差异有统计学意义(P<0.05)。Logistic回归分析显示,NSE、CA153、CA199、CEA是影响脑胶质瘤患者预后的独立因素(P<0.05)。结论NSE、CA153、CA199、CEA对脑胶质瘤具有一定的诊断价值,联合诊断效能更佳,是影响脑胶质瘤患者预后的独立因素。Objective To investigate the diagnostic value of carbohydrate antigen(CA)199,neuron specific enolase(NSE),CA153 and carcinoembryonic antigen(CEA)in the diagnosis of gliomas and their relationship with prognosis.Methods Totally 52 patients with gliomas in our hospital from August 2017 to September 2019 were selected as the brain glioma group,and 60 patients with intracranial pressure after traumatic brain injury were selected as the control group.The levels of CA199,NSE,CA153 and CEA were detected by enzyme-linked immunosorbent assay.The diagnostic value of CA199,NSE,CA153 and CEA in the diagnosis of glioma was evaluated by receiver operating characteristic curve,and the diagnostic efficacy of combined detection and single detection of four indicators was compared.Logistic regression was used to analyze the relationship between the four indexes and the prognosis of patients.Results The serum levels of CA199,NSE,CA153 and CEA in brain glioma group were significantly higher than those in control group(P<0.05);Compared with low-grade brain glioma patients,the serum levels of CA199,NSE,CA153 and CEA in high-grade brain glioma patients were significantly higher(P<0.05).The area under the curve of NSE,CA199,CA153,CEA of single detection was 0.709(95%CI:0.616-0.791),0.859(95%CI:0.781-0.918),0.782(95%CI:0.694-0.854),0.630(95%CI:0.694-0.854).The combined diagnostic sensitivity,specificity and accuracy of NSE,CA199,CA153 and CEA were 88.46%,81.67%and 84.82%,respectively.The combined diagnostic sensitivity and accuracy of the four indexes were significantly higher than those of single detection(P<0.05).Compared with the good prognosis group,the serum levels of CA199,NSE,CA153 and CEA in the poor prognosis group were significantly higher(P<0.05).Logistic regression analysis showed that NSE,CA153,CA199 and CEA were independent prognostic factors(P<0.05).Conclusion NSE,CA153,CA199 and CEA have certain diagnostic value for brain glioma,and the combined diagnosis is more effective,which is an independent prognostic factor for bra

关 键 词：脑胶质瘤 糖类抗原199 神经元特异性烯醇化酶 糖类抗原153 癌胚抗原 

分 类 号：R739.41[医药卫生—肿瘤]