细胞角蛋白19片段检测对肺癌的诊断价值

Diagnosis value of serum CYFRA21-1 level in lung cancer

目的 探讨血清细胞角蛋白19片段（CYFRA21-1）检测对肺癌的诊断价值.方法 采用电化学发光免疫（ECLIA）技术分别对196例肺癌患者和39名体检健康人员的血清标本进行CYFRA21-1含量检测,分析其表达对临床诊断的意义.结果 肺癌组血清CYFRA21-1（范围为0.30～500.00μg/L）与对照组（范围为0.27～3.29μg/L）相比均明显升高,差异有统计学意义（Z值为-4.65,P〈0.01）.诊断效能ROC分析显示曲线下面积为0.735（P〈0.001）,95%CI,为0.663～0.807.CYFRA21-1检测阳性率鳞癌为48.8%（39/80）,腺癌为31.7%（20/63）,小细胞肺癌为22.6%（12/53）,总阳性率为36.2%（71/196）.逐步直线回归分析显示cYFRA21-1与鳞状细胞癌、肝转移和骨转移有直线相关关系（r=0.505,P〈0.05）.结论 CYFRA21-1检测对肺癌有辅助诊断价值,初步判断病理类型,监测肝和骨转移以及对临床治疗方案的制定与调整具有一定指导意义.

Objective To evaluate the clinical application of serum CYFRA21-1 detection during the diagnosis of lung cancer. Methods Serum level of CYFRA21-1 in 196 patients with lung cancer and 39 healthy controls were determined by the Elctro-chemiluminescence Immuno-assay （ ECLIA） , respectively. Results Serum level of CYFRA21 -1 （ range from 0. 30 μgg/L to 500.00 μg/L） in patients with lung cancer were significantly higher than those in the healthy control （ range from 0. 27 μg/L to 3. 29 μg/L,Z = -4. 65,P 〈 0.01）. ROC analysis of diagnosis efficiency showed that the area under curve （ AUC） was 0. 735 （P 〈 0. 001 ）. The confidence interval of 95% was from 0. 663 to 0. 807. Positive detection rate of CYFRA21-1 was 48. 8% （39/80） in squamous,31.7% （20/63） in adenocarcinoma and 22. 6% （12/53） in small cell lung cancer （SCLC） respectively, as well as total positive rate was 36. 2% （71/196）. Stepwise regression analysis showed that serum level of CYFRA21-1 had a linear correlation with the squamous and the metastasis to liver or bone （r =0. 505 ,P 〈0. 05）. Conclusions Serum level of CYFRA21-1 increases the diagnostic sensitivity, which is helpful for determining histological types, monitoring the metastasis of liver and bone, and evaluating the treatment response in patients with lung cancer.