八项肿瘤标志物在肺癌早期诊断的临床研究  

Clinical research of 8 tumor markers in early diagnosis of lung cancer

作　　者：林晓燕[1] 曾芸珠 林雪琼[3] LIN Xiaoyan;ZENG Yunzhu;LIN Xueqiong(Department of Clinical Laboratory,the People's Hospital of Chenghai Shantou,Guangdong,Shantou 515000,China;Department of Pathology,Tumor Hospital Affiliated to Shantou University Medical College,Guangdong,Shantou 515000,China;Department of Clinical Laboratory,Tumor Hospital Affiliated to Shantou University Medical College,Guangdong,Shantou 515000,China)

机构地区：[1]广东省汕头市澄海区人民医院检验科,广东汕头515000 [2]汕头大学医学院附属肿瘤医院病理科,广东汕头515000 [3]汕头大学医学院附属肿瘤医院检验科,广东汕头515000

出　　处：《中国医药科学》2021年第11期142-145,156,共5页China Medicine And Pharmacy

基　　金：广东省汕头市第二批医疗卫生科技计划项目(汕府科﹝2020﹞58号-57)。

摘　　要：目的探究糖类抗原125(CA125)、糖类抗原199(CA199)、糖类抗原72-4(CA72-4)和细胞角蛋白19片段(CYFRA21-1)、鳞癌相关抗原(SCC)、胃泌素释放肽前体(ProGRP)、神经元特异性烯醇化酶(NSE)、癌胚抗原(CEA)检测在肺癌诊断中的效果,并对临床价值进行分析。方法选取2018年12月至2020年9月于汕头市澄海区人民医院就诊的肺癌患者94例为肺癌组,同期收治的肺部良性病变患者60例为良性肺病组和体检健康人群70例为健康组,检测三组对象各项肿瘤标志物水平,比较它们单独及联合检测的诊断效能。结果肺癌组CA125、CYFRA21-1、SCC、ProGRP、NSE和CEA水平均高于良性肺病组与健康组(P<0.05)。肺癌组八项血清TM阳性检出率高于健康组和良性肺病组(P<0.05)。八项指标联合检测的曲线下面积(AUC)、灵敏度和特异度高于各单项检测。单项检测CYFRA21-1的AUC最大,灵敏度最高;CA72-4的AUC最小,灵敏度最低。结论血清CA125、CYFRA21-1、SCC、ProGRP、NSE和CEA均为肺癌诊断的良好指标。联合检测是提高肺癌诊断效能的有效方法。其中CYFRA21-1是诊断肺癌的最佳指标,CA72-4对肺癌的诊断价值不高。Objective To investigate the detection effects of carbohydrate antigen 125(CA 125),carbohydrate antigen 199(CA 199),carbohydrate antigen 72-4(CA 72-4),seru m cytokeratin 19 fragment(CYFRA21-1),squamous cell carcinoma associated antigen(SCC),pro-gastrin releasing peptide(ProGRP),neuron specific enolase(NSE)and carcinoembryonic antigen(CEA)in the diagnosis of lung cancer and analyze the clinical value.Methods Patients with lung cancer treated in People's Hospital of Chenghai Shantou from December 2018 to September 2020 were selected as the lung cancer group(n=94),those with benign lung diseases admitted in the same period were selected as the benign lung disease group(n=60),and healthy people undergoing physical examination were selected as the healthy group(n=70).The levels of all tumor markers in the three groups of objects were detected,and the diagnostic efficiencies of their separate and combined detection were compared.Results The levels of CA125,CYFRA21-1,SCC,ProGRP,NSE and CEA in the lung cancer group were all higher than those in the benign lung disease group and the healthy group(P<0.05).The positive rate of 8 serum TM in the lung cancer group was higher than that in the healthy group and the benign lung disease group(P<0.05).The area under the curve(AUC),sensitivity and specificity of combined detection of 8 indices were higher than those of separate detection.The AUC of CYFRA21-1 was the largest and the sensitivity was the highest.The AUC of CA72-4 was the smallest and the sensitivity was the lowest.Conclusion The serum CA125,CYFRA21-1,SCC,ProGRP,NSE and CEA are all good indices for the diagnosis of lung cancer.Combined detection is an effective method to improve the diagnostic efficiency of lung cancer.Among them,CYFRA21-1 is the best index for diagnosing lung cancer,while CA72-4 is of low diagnostic value for lung cancer.

关 键 词：肺癌 肿瘤标志物 血清细胞角蛋白19片段 糖类抗原72-4 

分 类 号：R734.2[医药卫生—肿瘤]