BSP、CEA和Cyfra21-1联合检测在NSCLC骨转移中的诊断价值

The Diagnostic Value of Combined Detection of BSP,CEA and Cyfra21-1 in Bone Metastasis of NSCLC

目的:探讨骨唾液酸蛋白(BSP)、血清癌胚抗原(CEA)和细胞角蛋白19(Cyfra21-1)联合检测在非小细胞肺癌(NSCLC)骨转移临床诊断中的应用价值。方法:将156例住院患者的血清标本按临床诊断不同分为NSCLC骨转移组(52例)、NSCLC无骨转移组(58例)及肺部良性病变组(46例)。对所有患者用酶联免疫吸附法(ELISA法)检测BSP,用电化学发光法检测CEA、CYFRA21-1含量。对比分析三组患者此3项指标检测结果及对NSCLC骨转移灵敏度、特异度的差异。结果:NSCLC骨转移组和无骨转移组患者血清CEA、Cyfra21-1含量明显高于肺部良性病变组;NSCLC骨转移组血清BSP含量明显高于无骨转移组和肺部良性病变组。血清BSP对NSCLC骨转移的灵敏度和特异度均高于CEA、Cyfra21-1的检测;BSP、CEA和Cyfra21-1联合检测的特异度较单一检测有明显的提高,且血清BSP水平增高的NSCLC患者1年内累计生存率明显低于BSP水平正常的患者。结论:BSP、CEA和Cyfra21-1联合检测不仅有效地提高了NSCLC骨转移患者诊断的特异性,而且在NSCLC骨转移危险的预测方面同样发挥着重要的作用。

Objective:To explore the diagnostic value of combined detection of bone saliva acid protein(BSP),serum carcino-embryonic antigen(CEA) and embryo Cytokeratins 19(Cyfra21-1) in bone metastasis of NSCLC.Methods:Serum samples of 156 patients were divided into NSCLC bone metastasis group(52 cases),NSCLC non-bone metastasis group(58 cases) and pulmonary benign lesions group(46 patients) on the basis of different clinical diagnosis.Serum level of BSP and CEA,CYFRA21-1 was detected by ELISA test and electrochemical luminescence method,repectively.The sensitivity and specificity of the three indexes on NSCLC bone metastasis were assessed.Results:Level of CEA and Cyfra21-1 in NSCLC bone metastasis group and non-bone metastasis group were obviously higher than those in lung benign lesions group;BSP level in NSCLC bone metastasis group was obviously higher than that in non-bone metastasis group and lung benign lesions group.The BSP expressed higher sensitivity and specificity of NSCLC bone metastasis compared with level of CEA and Cyfra21-1;and the specificity of combined detection of BSP,CEA and Cyfra21-1 on NSCLC bone metastasis was significantly greater than that of single.The accumulative total survival rate of 1 year in patients with higher serum level of BSP was lower as compared with patients with normal BSP level.Conclusions:The combined detection of BSP,Cyfra21-1 and CEA not only improved effectively the diagnostic specificity of NSCLC bone metastasis and played an important role in risk prediction of the NSCLC bone metastasis.