评价酶联免疫检测血清CYFRA21-1对非小细胞肺癌的诊断价值

DIAGNOSTIC VALUE OF SERUM CYFRA 21 1 BY ELISA FOR NON SMALL CELL LUNG CANCER

目的评价检测ＣＹＦＲＡ２１┐１对非小细胞肺癌的诊断价值。方法用ＥＬＩＳＡ法测定７０例肺癌（ＬＣ）其中４７例非小细胞肺癌（ＮＳＣＬＣ），３例小细胞肺癌（ＳＣＬＣ）和２０例未分型肺癌、６４例肺部良性疾病患者及４０例健康人血清ＣＹＦＲＡ２１┐１浓度。试验的诊断性能用相对操作特征（ＲＯＣ）分析法估测之。结果测得全阈诊断准确率（ＯｖｅｒａｌＤｉａｇ┐ｎｏｓｔｉｃＡｃｃｕｒａｃｉｅｓ）ＬＣ为０．７５、ＮＳＣＬＣ为０．７６，ＳＱＣ为０．８３，ＡＤＥ为０．６７和ＳＣＬＣ为０．３８。在相应于特异性为０．９５的界定值３．４７μｇ／Ｌ处，各型的灵敏度分别为ＳＱＣ０．６２，ＬＣ０．５３，ＮＳＣＬＣ０．５１，ＡＤＥ０．４８和ＳＣＬＣ０．００。结论结果显示ＣＹＦＲＡ２１┐１是ＮＳＣＬＣ较灵敏和特异的一个标志物。未观察到ＴＮＭ各期间该标志物的平均水平有明显的差异；然而异常升高水平的患者的比例随病期的进展而显著增加，提示一系列检测ＣＹＦＲＡ２１┐１水平可能有助于监查ＮＳＣＬＣ患者的疗效。

Objective:To evaluate the usefullness of CYFRA 21 1 assay in the diagnosis of non small cell lung cancer.Methods:Concentrations of CYFRA 21 1 were determined by ELISA in sera from 70 patients with lung cancer (LC) (47 NSCLC, 3 SCLC and 20 untyping LC),64 with benign lung diseases (BLD)and 40 healthy donors (HD). The diagnostic performance was estimated by relative operating characteristic (ROC) analysis.Results:The overall diagnostic accuracies were 0.75 for LC, 0.76 for NSCLC, 0.83 for squamous carcinoma(SQC), 0.67 for adenocarcinoma (ADE) and 0.38 for SCLC.By using a cut off value of 3.47 μg/L at specificity equal to 0.95,the sensitivities attained to 0.62 for for SQC,0.53 for LC, 0.51 for NSCLC, 0.48 for ADE and 0.00 for SCLC respectively. Conclusions:The results showed that CYFRA 21 1 was a more sensitive and specific marker for NSCLC, especially for SQC. Insignificant difference was observed in average levels of this marker between the TNM stages; however,proportions of the patients with NSCLC that showed abnormally elevated levels of the marker significantly with the progress of the stage, suggesting that a serial assays of the marker may be useful in monitoring therapeutic effects on NSCLC.