叶酸受体阳性循环肿瘤细胞联合肿瘤标记物检测对NSCLC诊断价值  

VALUE OF FOLATE RECEPTOR-POSITIVE CIRCULATING TUMOR CELLS COMBINED WITH TUMOR MARKERS IN THE DIAGNOSIS OF NON-SMALL CELL LUNG CANCER

作　　者：秦坤[1] 金翔凤[1] 衣腾飞 李烁 孙昭赟 刘玉洪[1] QIN Kun;JIN Xiangfeng;YI Tengfei;LI Shuo;SUN Zhaoyun;LIU Yuhong(Department of Thoracic Surgery,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院胸外科,山东青岛266003 [2]复旦大学附属上海市第五人民医院

出　　处：《青岛大学学报（医学版）》2021年第1期73-76,共4页Journal of Qingdao University(Medical Sciences)

基　　金：山东省医药卫生科技发展计划项目(2018WS383)。

摘　　要：目的探讨叶酸受体阳性循环肿瘤细胞(FR+-CTCs)联合肿瘤标志物外周血癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)检测在非小细胞肺癌(NSCLC)诊断中的价值。方法对146例NSCLC病人(肺癌组)、25例肺良性疾病病人(肺良性疾病组)和20例健康体检者(健康对照组)的CEA、CYFRA21-1和FR^+-CTCs检测结果进行回顾性分析,利用受试者工作特征(ROC)曲线分析各指标诊断价值。结果肺癌组FR^+-CTCs阳性率(75.3%)较健康对照组(5.0%)和肺良性病变组(8.0%)明显升高(χ^2=11.412,P<0.01)。肿瘤直径和肿瘤分期是影响NSCLC病人FR^+-CTCs表达的主要因素(Z=2.354,P<0.01;H=9.924,P<0.01),与病人的年龄、性别、有无吸烟史无关(P>0.05)。NSCLC组CEA、CYFRA21-1及FR^+-CTCs联合检测的曲线下面积(AUC)为0.778(95%CI=0.720~0.816),诊断灵敏度为77.50%,特异度为78.08%,与CYFRA21-1、CEA联合检测(AUC=0.707,95%CI=0.660~0.756,诊断灵敏度为66.53%,特异度为71.95%)相比有更高的诊断价值。结论FR^+-CTCs联合肿瘤标志物CEA、CYFRA21-1检测可提高NSCLC诊断的灵敏度及特异度。Objective To investigate the value of folate receptor-positive circulating tumor cells(FR+-CTCs)combined with the tumor markers carcinoembryonic antigen(CEA)and cytokeratin 19 fragment(CYFRA21-1)in the diagnosis of non-small lung-cancer(NSCLC).Methods A retrospective analysis was performed for the Results of CEA,CYFRA21-1,and FR^+-CTCs of 146 patients with NSCLC(NSCLC group),25 patients with benign lung diseases(benign lung disease group),and 20 individuals who underwent physical examination(healthy control group),and the receiver operating characteristic(ROC)curve was used to investigate the diagnostic value of each index.Results The NSCLC group had a significantly higher positive rate of FR^+-CTCs than the healthy control group and the benign lung disease group(75.3%vs 5.0%/8.0%,χ^2=11.412,P<0.01).Tumor diameter and tumor stage were the main factors affecting the expression of FR^+-CTCs in the patients with NSCLC(Z=2.354,P<0.01;H=9.924,P<0.01),which was not associated with age,sex,and smoking history(P>0.05).In the NSCLC group,the combined measurement of CEA,CYFRA21-1,and FR+-CTCs had an area under the ROC curve(AUC)of 0.778(95%CI=0.720-0.816),a diagnostic sensitivity of 77.50%,and a specificity of 78.08%,while the combined measurement of CEA and CYFRA21-1 had an AUC of 0.707(95%CI=0.660-0.756),a diagnostic sensitivity of 66.53%,and a specificity of 71.95%,suggesting that the combined measurement of CEA,CYFRA21-1,and FR^+-CTCs had a higher diagnostic value than the combined measurement of CEA and CYFRA21-1.Conclusion FR^+-CTCs combined with the tumor markers CEA and CYFRA21-1 can improve the sensitivity and specificity of the diagnosis of NSCLC.

关 键 词：肿瘤细胞 循环 癌 非小细胞肺 癌胚抗原 角蛋白19 

分 类 号：R734.2[医药卫生—肿瘤]