NSE、CYFRA21-1、CA125、CA19-9、CEA联合检测在抑郁症伴肺癌诊断中的价值

The Value of Combined Detection of NSE,CYFRA21-1,CA125,CA19-9 and CEA in the Diagnosis of Depression with Lung Cancer

目的探讨NSE、CYFRA21-1、CA125、CA19-9和CEA在抑郁症伴肺癌患者诊断中的价值。方法选择2010年12月至2015年12月收治的抑郁症伴肺癌的患者46例纳入A组,收集同期单纯肺癌患者50例纳入B组和健康体检者50例纳入C组。检测入选者血清NSE、CYFRA21-1、CA125、CA19-9和CEA浓度。采用17项汉密顿抑郁量表(HAMD)对抑郁症患者进行评定。结果 A组和B组患者血清NSE、CYFRA21-1、CA125、CA19-9和CEA浓度均显著高于对照组,差异有统计学意义(P<0.05)。A组与B组比较,血清NSE、CYFRA21-1、CA125、CA19-9和CEA浓度无统计学差异(P>0.05)。小细胞肺癌患者中血清NSE的浓度显著升高(P<0.05);鳞癌患者中血清CYFRA21-1浓度显著升高(P<0.05);腺癌患者中血清CA125浓度显著升高(P<0.05)。5种肿瘤标志物诊断抑郁症伴肺癌敏感度由高到低依次为NSE(0.652)、CA125(0.598)、CYFRA21-1(0.549)、CEA(0.530)和CA19-9(0.437);特异度由高到低依次为CYFRA21-1(0.838)、NSE(0.820)、CA19-9(0.819)、CA125(0.718)和CEA(0.659)。联合检测的曲线下面积(AUC)为0.826,显著高于任何一种单一标志物(P<0.05)。结论抑郁症伴肺癌患者血清NSE的浓度与抑郁症的严重程度正相关,联合NSE、CYFRA21-1、CA125、CA19-9和CEA能显著提高抑郁症伴肺癌患者的检出率。

Objective To explore the value of NSE,CYFRA21-1,CA125,CA19-9 and CEA in the diagnosis of lung cancer patients with depression.Methods 46 cases of depression with lung cancer was group A,50 cases of lung cancer patients was group B and 50 cases of healthy patients was group C.The serum levels of NSE,CYFRA21-1,CA125,CA19-9 and CEA were detected.17 item hamilton depression scale（HAMD） were used to assess patients with depression.Results The serum levels of NSE,CYFRA21-1,CA125,CA19-9 and CEA in group A and group B were significantly higher than those of group C,the difference was statistically significant（P〈0.05）.There was no significant difference in serum NSE,CYFRA21-1,CA125,CA19-9 and CEA concentrations between group A and group B（P〉0.05）.The serum NSE concentration in patients with non-small cell lung cancer was significantly higher（P〈0.05）,the serum CYFRA21-1 concentration was significantly higher in patients with squamous cell carcinoma（P〈0.05）,and the serum CA125 concentration was significantly increased in patients with adenocarcinoma（P〈0.05）.The sensitivity of tumor markers in the diagnosis of depression with lung cancer from high to low were NSE（0.652）,CA125（0.598）,CYFRA21-1（0.549）,CEA（0.530） and CA19-9（0.437）; specificity from high to low were CYFRA21-1（0.838）,NSE（0.820）,CA19-9（0.819）,CA125（0.718） and CEA（0.659）.The area under the curve（AUC） was 0.826 of combined detection,which was significantly higher than that of any single marker（P〈0.05）.Conclusion The concentration of serum NSE in patients with depression and lung cancer is positively correlated with the severity of depression.Combined detection of NSE,CYFRA21-1,CA125,CA19-9 and CEA can significantly improve the detection rate of depression patients with lung cancer.