支气管肺泡灌洗液液基细胞学联合肿瘤标志物鉴别良恶性孤立性肺结节的价值  

The value of bronchoalveolar lavage fluid liquid-based cytology combined with tumor markers in distinguishing benign and malignant solitary pulmonary nodules

作　　者：李斌[1] 白东明[1] 杨晓辉 Li Bin;Bai Dongming;Yang Xiaohui(Department of Thoracic Surgery,Dezhou People’s Hospital,Dezhou 253000,China)

机构地区：[1]山东省德州市人民医院胸外科,德州253000

出　　处：《广西医科大学学报》2021年第11期2168-2172,共5页Journal of Guangxi Medical University

基　　金：山东省医药卫生科技发展计划项目(No.2015WS0465)。

摘　　要：目的:探讨支气管肺泡灌洗液(BALF)液基细胞学(LCT)联合肿瘤标志物细胞角蛋白片段21-1(CYFRA21-1)、癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)鉴别良恶性孤立性肺结节(SPN)的价值。方法:选取2017年5月1日至2020年5月1日在山东省德州市人民医院胸外科收治的SPN患者107例,均行BALF LCT检测,采用电化学发光法检测BALF中CEA、CYFRA21-1和NSE的含量,采用logistic回归进行联合诊断,采用受试者工作特征曲线(ROC)评估诊断效能。结果:107例SPN患者中有63例(58.9%)为恶性SPN。恶性SPN患者中CEA、CYFRA21-1及NSE的含量均高于良性SPN(P<0.05)。BALF LCT检测联合肿瘤标志物CEA、CYFRA21-1和NSE的ROC曲线下面积(AUC)、准确度、敏感度和特异度分别0.801(95%CI:0.718~0.847)、0.720(95%CI:0.718~0.722)、0.803(95%CI:0.731~0.875)、0.743(95%CI:0.705~0.822),均高于单一诊断指标(P<0.05)。结论:BALF LCT联合肿瘤标志物CEA、CYFRA21-1和NSE检测可提高SPN的诊断价值。Objective:To investigate the value of bronchoalveolar lavage fluid(BALF) liquid-based cytology test(LCT) combined with cytokeratin 19 fragment(CYFRA21-1),carcinoembryonic antigen(CEA) and neuron specific enolase(NSE) in distinguishing benign and malignant solitary pulmonary nodules(SPN).Methods:A total of 107 SPN patients were enrolled in the study.All patients underwent BALF LCT detection.Electrochemical luminescence method was used to detect the contents of CEA,CYFRA21-1 and NSE in BALF.Logistic regression was used for joint diagnosis,and receiver operating characteristic curve(ROC) was used to evaluate the diagnostic efficacy.Results:Sixty-three(58.9%) of 107 SPN patients were malignant SPN.The levels of CEA,CYFRA21-1 and NSE in patients with malignant SPN were higher than those with benign SPN(P<0.05).The AUC,accuracy,sensitivity,and specificity of BALF LCT combined with tumor markers of CEA,CYFRA21-1 and NSE were 0.801(95% CI:0.718-0.847),0.720(95% CI:0.718-0.722),0.803(95% CI:0.731-0.875),and0.743(95% CI:0.705-0.822) respectively,which were higher than those of the single diagnostic index(P<0.05).Conclusion:BALF LCT detection combined with tumor markers CEA,CYFRA21-1 and NSE can improve the diagnostic value of SPN.

关 键 词：肺癌 孤立性肺结节 支气管肺泡灌洗液 液基细胞学 

分 类 号：R734.2[医药卫生—肿瘤]