多项肿瘤标志物联合肿瘤直径对肺癌病理分型的判别  

Identification of Multiple Tumor Markers Combined with Tumor Diameter for Pathological Classification of Lung Cancer

作　　者：王馨珩 张蕴莉 Wang Xinheng;Zhang Yunli(The First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000 China)

机构地区：[1]锦州医科大学附属第一医院,辽宁锦州121000

出　　处：《锦州医科大学学报》2023年第4期92-96,共5页Journal of Jinzhou Medical University

基　　金：辽宁省科学技术基金项目,项目编号:JYTQN2020019。

摘　　要：目的通过研究肺癌患者的血清学、影像学及其他临床数据,构建风险评估模型,对肺癌进行多学科融合诊断,之后与已明确的病理类型相比较,研判此分析模型的肺癌符合率。方法收集锦州医科大学附属第一医院2022年1月至2022年9月住院并经病理诊断为肺癌共200例患者的病理结果、癌胚抗原(carcinoembryonic antigen,CEA)、胃泌素释放肽前体(pro-gastrin releasing peptide,ProGRP)、细胞角蛋白19片段(cytokeratin-19-fragment,CYFRA21-1)等血清学结果及相关临床资料。所有患者均行256排螺旋CT扫描,利用CT读片软件分别测得瘤体长径(R_(长))及短径(R_(短)),计算出肿瘤的横截面积(S)。通过判别分析模型对肺癌患者的病理类型予以预判。结果3组组间性别比存在统计学意义,卡方分割检验显示组内比较差异均具有统计学意义(P<0.05)。对3组组间血清学肿瘤标志物的分析存在统计学意义,3组组间比较提示:肺鳞癌与其他两组间CYFRA21-1差异有统计学意义(P<0.05)、3组组间ProGRP差异有统计学意义(P<0.001)。3组组间R_(长)、R_(短)及S差异均有统计学意义(P<0.001)。经进一步判别分析提示总体判别符合率为78.4%,其中肺腺癌判别符合率95.0%,肺鳞癌判别符合率41.7%,小细胞肺癌判别符合率60.4%,诊断拟合度Kappa=0.57,P<0.001,经判别分析提示CYFRA21-1、R_(长)、R_(短)及S与各病理类型具有相关性。结论多项肿瘤标志物联合肿瘤直径对肺癌病理类型具有一定的判别作用。Objective To establish a risk assessment model by studying serological,imaging and other clinical data of lung cancer patients,and conduct multidisciplinary fusion diagnosis of lung cancer,and then compare with the established pathological types to determine the lung cancer coincidence rate of this analysis model.Methods The pathological results,carcinoembryonic antigen,gastrin-releasing peptide precursor,cytokeratin 19 fragment and other serological results and related clinical data of 200 patients admitted to the First Affiliated Hospital of Jinzhou Medical University from January 2022 to September 2022 who were pathologically diagnosed with lung cancer were collected.All patients underwent 256-slice spiral CT scanning.The long diameter(R length)and short diameter(R short)of tumor were measured by CT scanning software,and the cross-sectional area(S)of tumor was calculated.The discriminant analysis model was used to predict the pathological types of lung cancer patients.Results There were statistical differences in sex ratio among the three groups,and Chi-square segmentation test showed that there were statistical differences in intra-group comparison(P<0.05).There were statistical differences in the analysis of serological tumor markers between the three groups,and the comparison between the three groups suggested that there was a certain statistical difference in CYFRA21-1 between the lung squamous cell carcinoma and the other two groups(P<0.05),and there was also a significant statistical difference in ProGRP between the three groups(P<0.001).There were significant differences in R_(length),R_(short) and S among the three groups(P<0.001).Further discriminant analysis suggested that the overall discriminant coincidence rate was 78.4%,including 95.0%for lung adenocarcinoma,41.7%for lung squamous cell carcinoma and 60.4%for small cell lung cancer.The diagnostic fit rate Kappa=0.57,P<0.001.Discriminant analysis showed that age,CYFRA21-1,R1,R2 and S were correlated with each pathological type.Conclusion Multiple t

关 键 词：肿瘤标志物 肿瘤直径 肺癌 判别分析 预测模型 

分 类 号：R734.2[医药卫生—肿瘤]