血清CA125、CYFRA21-1、CEA、NSE及ALP联合检测对原发性肺癌患者骨转移的预测价值

Predictive Value of Combined Detection of Serum CA125,CYFRA21-1,CEA,NSE,and ALP for Bone Metastasis in Primary Lung Cancer Patients

目的探究血清糖类抗原125(CA125)、细胞角蛋白19片段抗原21-1(CYFRA21-1)、癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)及碱性磷酸酶(ALP)联合检测对原发性肺癌患者骨转移的预测价值。方法选取肺癌患者104例为观察组,并根据是否发生骨转移分为骨转移组(50例)和无骨转移组(54例)。同时选取100例肺部良性病变者为对照组。收集肺癌患者临床资料,检测所有受试者血清CA125、CYFRA21-1、CEA、NSE及ALP水平。采用受试者工作特征(ROC)曲线分析血清CA125、CYFRA21-1、CEA、NSE、ALP对肺癌患者骨转移的预测价值。采用多因素Logistic回归分析肺癌患者骨转移的影响因素。结果与对照组相比,观察组血清CA125、CYFRA21-1、CEA、NSE、ALP水平显著升高(P<0.05)。骨转移组中临床分期Ⅲ~Ⅳ期患者占比、有淋巴结转移患者占比及血清CA125、CYFRA21-1、CEA、NSE、ALP水平显著高于无骨转移组(P<0.05)。血清CA125、CYFRA21-1、CEA、NSE、ALP预测肺癌患者发生骨转移的AUC分别为0.818、0.816、0.739、0.770、0.771,5种肿瘤标志物联合检测的AUC为0.955,敏感度、特异度、AUC均显著高于各肿瘤标志物单独检测(P<0.05)。多因素Logistic回归分析显示,CA125、CYFRA21-1、CEA、NSE、ALP是影响肺癌患者发生骨转移的危险因素(P<0.05)。结论血清CA125、CYFRA21-1、CEA、NSE、ALP联合检测对原发性肺癌患者骨转移的预测具有较高的价值,联合诊断效能更高。

Objective To explore the predictive value of combined detection of serum carbohydrate antigen 125(CA125),cytokeratin 19 fragment antigen 21-1(CYFRA21-1),carcinoembryonic antigen(CEA),neuron specific enolase(NSE),and alkaline phosphatase(ALP)for bone metastasis in primary lung cancer patients.Methods A total of 104 lung cancer patients who received treatment were collected as the observation group,and grouped into a bone metastasis group(50 cases)and a non bone metastasis group(54 cases)based on whether bone metastasis occurred.100 cases of benign lung lesions were collected as the control group.Clinical data of lung cancer patients were collected,the serum levels of CA125,CYFRA21-1,CEA,NSE,and ALP were detected in all subjects.Receiver operating characteristic(ROC)curve was applied to analyze the predictive value of serum CA125,CYFRA21-1,CEA,NSE,and ALP for bone metastasis in lung cancer patients.Multivariate Logistic regression was applied to analyze the influencing factors of bone metastasis in lung cancer patients.Results Compared with the control group,the serum levels of CA125,CYFRA21-1,CEA,NSE,and ALP in the observation group were obviously increased(P<0.05).The number of clinical stagesⅢ~Ⅳ,number of lymph node metastasis,and serum levels of CA125,CYFRA21-1,CEA,NSE,and ALP in the bone metastasis group were obviously higher than those in the non bone metastasis group(P<0.05).The AUC of serum CA125,CYFRA21-1,CEA,NSE,and ALP in predicting bone metastasis in lung cancer patients was 0.818,0.816,0.739,0.770,and 0.771,respectively,the AUC of combined detection of five tumor markers was 0.955,and the sensitivity,specificity,and AUC were obviously higher than those of individual detection of each tumor marker(P<0.05).Multivariate Logistic regression analysis showed that CA125,CYFRA21-1,CEA,NSE,and ALP were risk factors for bone metastasis in lung cancer pa-[CM(51]tients(P<0.05).Conclusion The combined detection of serum CA125,CYFRA21-1,CEA,NSE,and ALP has high value in[CM)][LM]predicting bone metastasis in primary lung cancer patients,and the combined diagnosis has higher efficiency.