肿瘤标志物联合检测对中老年肺结核合并肺癌的诊断价值研究

Researches on the diagnosis value of tumor markers combined detection to middle-aged patients with pulmonary tuberculosis complicating lung cancer

目的:探讨癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、细胞角蛋白片段(CYFRA21-1)、糖类癌抗原(CA125)、糖类癌抗原199(CA199)、甲胎蛋白(AFP)6种肿瘤标志物联合检测对中老年肺结核合并肺癌的诊断价值。方法:选取在我院治疗的肺结核合并肺癌患者52例(A组),肺结核患者76例(B组)以及同期在我院体检的健康人群118例(C组),检测各组CEA、NSE、CYFRA21-1、CA125、CA199和AFP等肿瘤标志物水平。结果:A组CEA、NSE、CYFRA21-1、CA125、CA199和AFP明显高于B组和C组,差异有统计学意义(P<0.05);B组和C组肿瘤标志物水平比较,差异无统计学意义(P>0.05);A组中小细胞肺癌患者CEA和CYFRA21-1明显高于非小细胞肺癌患者,而NSE低于非小细胞肺癌患者(P<0.05);小细胞肺癌患者和非小细胞肺癌患者CA125、CA199和AFP比较,差异无统计学意义(P>0.05);CEA的灵敏度最高(50.00%),CA199的特异度最高(91.24%)。6种肿瘤标志物联合检测的灵敏度为71.15%,特异度为89.69%。结论:CEA、NSE、CYFRA21-1、CA125、CA199和AFP联合检测有利于肺结核合并肺癌的诊断,有一定的临床价值。

Objective:To discuss the diagnosis value of six kinds of tumor markers(CEA,NSE,CYFRA21-1,CA125,CA199,AFP)combined detection to middle-aged patients with pulmonary tuberculosis complicating lung cancer.Methods:A total of 52 cases with pulmonary tuberculosis complicating lung cancer who were admitted in our hospital were selected as Group A and 76 cases with pulmonary tuberculosis were selected as Group B,and 118 cases with physical examination during the corresponding period were selected as Group C.Tumor markers(CEA,NSE,CYFRA21-1,CA125,CA199 and AFP)levels of patients in each group were detected.Results:CEA,NSE,CYFRA21-1,CA125,CA199 and AFP levels of patients in Group A were significantly higher than that in Group B and C showing significant differences(P<0.05);Difference in tumor markers levels between B Group and C Group was not significantly different(P>0.05);CEA and CYFRA21-1levels of patients with small cell lung cancer in Group A were significantly higher than those patients with non-small cell lung cancer,but NSE level was lower than those patients with non-small cell lung cancer(P<0.05);comparative difference of CA125,CA199and AFP levels between small cell lung cancer patients and non-small cell lung cancer patients showed no statistical significance(P>0.05).Sensitivity of CEA was the highest(50.00%),specificity of CA199 was the highest(91.24%).Sensitivity of 6kinds of tumor markers combined detection was 71.15%,and specificity was 89.69%.Conclusion:Combined detection of CEA,NSE,CYFRA21-1,CA125,CA199 and AFP had a certain clinical value for the diagnosis of pulmonary tuberculosis complicating lung cancer.