比较肺癌患者细胞角蛋白19-2G2及其它血清学诊断指标

The comparison of CK19-2G2 and other serologic markers in lung cancer diagnosis

目的:探讨细胞角蛋白19-2G2(CK19-2G2)与血清学检测其它指标在肺癌诊断中的临床应用。方法:用化学发光免疫分析法测定71例肺癌患者血清CK19-2G2,并同步检测临床肿瘤诊断常用的血清学指标CEA、NSE、Cyfra21-1,与52例肺部良性疾病和40例健康体检者进行对照比较,计算单项或联合检测的敏感性和特异性,绘制KOC曲线,计算KOC曲线下面积。结果:单指标检测,CK19-2G2对肺癌的诊断敏感性为69.01%,特异性为95.56%,高于CEA、NSE、Cyfra21-1;CK19-2G2的ROC曲线下面积最大(0.783,95%可信区间0.699～0.868),临床诊断效能高于CEA、NSE、Cyfra21-1;多指标联合检测,敏感性可提高至84.51%,且敏感性和特异性之和最大。结论:CK19-2G2为一高度敏感的肺癌诊断血清学标志物,其与CEA、NSE、Cyfra21-1联合检测,对于早期筛查和辅助诊断肺癌有重要意义。

Objective：To evaluate the diagnostic value of CK19-2G2,CEA,NSE and Cyfra21-1 in the patients with lung cancer.Methods： Chemiluminescence immunoassay was used to detect the serum CK19-2G2 in 71 patients with lung cancer,52 patients with benign lung diseases and 40 healthy individuals.The CEA,NSE and Cyfra21-1 were detected simultaneously.The sensitivity and specificity of single or combined biomarkers were evaluated,Roc curves were protracted and the area below ROC curve was calculated.Results： Single-biomarker detection showed that sensitivity and specificity of CK19-2G2 were 69.01% and 95.56%,respectively,higher than CEA,NSE and Cyfra21-1,with the largest area below ROC curve（area：0.783;95%credible interval 0.699-0.868）.Multi-biomarkers detection showed that sensitivity could be raised to 84.51%,with the sum of sensitivity and specificity being the biggest.Conclusion： CK19-2G2 was a highly sensitive adjunctive marker for detecting lung cancer,and has an important role in screening for early stage lung cancer patients when combined with CEA,NSE and Cyfra21-1.