CEA和CYFRA21-1在原发性肺癌诊断中的应用价值分析

Analysis of the Application Value of CEA and CYFRA21-1 in the Diagnosis of Primary Lung Cancer

目的：评价血清癌胚抗原（carcinoembryonic antigen,CEA）和细胞角蛋白19的片段（CYFRA21-1）水平对原发性肺癌的诊断价值。方法：回顾性分析2012年5月～2013年5月我科收治的329例肺癌患者和192例肺部良性病变患者的临床资料。结果：肺癌患者血清CEA或CYFRA21-1水平随着肺癌的分期呈现逐渐上升的趋势（P〈0.001,P〈0.01）。以血清CEA≥3.4μg/L作为诊断条件诊断肺癌的灵敏度、特异度和阳性预计值预计值分别为67%、62%和75.2%；以血清CYFRA-21≥5.0 ug/L作为诊断条件诊断原发性肺癌的灵敏度、特异度和阳性预计值预计值分别为48%、87%和86.3%；以血清CEA≥3.4 ug/L和CYFRA-21≥5.0 ug/L共同作为诊断条件推断原发性肺癌的灵敏度、特异度和阳性预计值预计值分别为48%、87%和86.3%；良性肺部疾病患者中血清CEA和CYFRA-21水平同时升高者只有2%。结论：血清CEA≥3.4 ug/L和CYFRA-21≥5.0 ug/L同时升高对肺癌有具有重要的诊断价值,可有效的鉴别原发性肺癌与其它良性病变。

Objective： Assess diagnostic value of CEA and CYFRA21-1 in primary lung cancer. Methods： A retrospective analysis was conducted on 329 patients treated for lung cancer and 192 patients treated for benign lung disease between May 2012 and May 2013.Results： The serum levels of CEA and CYFRA21-1 showed a tendency to be increased in the more advanced stages of lung cancer. Sensitivity, specificity and positive predictive values of CEA in the diagnosis of primary lung cancer was 67%, 62% and 75.2 % using 3.2ug/L as the cut-off level, respectively. Sensitivity, specificity and positive predictive values of CYFRA21-1 in the diagnosis of primary lung cancer was 48%, 87% and 86.3% using 5.0 ug/L as the cut-off level, respectively. Sensitivity, specificity and positive predictive values with the combination of positive CEA and positive CYFRA 21-1 in the diagnosis of primary lung cancer was 13%, 98% and 91.3%using the cut-off level, respectively. The combination of positive CEA and positive CYFRA21-1 at the cut-off level in the benign disease was only 2%. Conclusion： Combining CEA and CYFRA 21-1 are reliable serum tumor markers for the diagnosis of lung cancer, if the prevalent rate of patients is high, are helpful to distinguish primary lung cancer from benign lung disease.