TAP及联合肺癌三项肿瘤标记物检测对肺癌的诊断价值

Diagnostic significance of separate and joint detection of TAP and three tumor biomarkers in lung cancer

目的探讨单独检测血清TAP及联合肺癌三项肿瘤标记物检测对肺癌的诊断价值。方法选取2015年5月-2017年2月于安徽医科大学第二附属医院呼吸内科住院的229例经组织病理学或细胞学确诊为肺癌的患者为肺癌组,选取同期在我科住院的肺部良性疾病患者125例为对照组,分别检测两组患者血清TAP、肺癌三项水平,比较TAP在两组人群中的变化,并通过比较TAP、肺癌三项及联合检测对肺癌诊断的灵敏度、特异度、阳性预计值、阴性预计值,来判断TAP单独及联合检测肺癌三项肿瘤标志物的价值。结果(1)肺癌组患者血清TAP阳性率明显高于对照组,差异有统计学意义(P<0.05);(2)小细胞肺癌组患者血清TAP凝集颗粒面积与鳞癌组、腺癌组比较明显增大,(P<0.05),但在鳞癌组与腺癌组之间比较无明显差异(P>0.05);(3)TAP、肺癌三项单独检测对肺癌诊断灵敏度无明显差异(P>0.05);(4)联合TAP、肺癌三项检测可提高肺癌诊断灵敏度(P<0.05)。结论肺癌患者血清TAP检测明显呈阳性,与肺癌三项联合检测可提高肺癌诊断的灵敏度。

Objective To investigate the clinical value of separate and joint detection of TAP and three tumor biomarkers （ CEA, NSE, Cyfra21-1 ） in the diagnosis of lung cancer patients. Methods 229 cases of lung cancer confirmed by pathology were enrolled in the second affiliated hospital of Anhui Medical University from June 2015 to February 2017, which were considered as the lung cancer group, and 125 cases of benign pulmonary diseases were enrolled into the control group. The serum levels of tumor markers （TAP, CEA, NSE and Cyfra21-1 ） were de- tected and compared in the two groups. The sensitivity, specificity, positive predictive value （PPV）, and negative predictive value （NPV） of single TAP and combination of CEA, NSE and Cyfra21-1 tumor biomarkers were analyzed in the diagnosis of lung cancer. Results The levels of TAP in lung cancer group were significantly higher than those in the control group （ P 〈 0. 05 ）. The particle agglutination area of TAP in the small cell lung cancer group were significantly larger than that in the squamous cell carcinoma and adenocarcinoma group （ P 〈 0. 05 ） , but there was no significant difference between the squamous cell carcinoma and adenocarcinoma group （ P〉0.05 ）. The separate detect of TAP or CEA, NSE, Cyfra21-1 had no significant difference between the two groups （ P 〉 0. 05 ）. The combined detection of TAP and lung cancer three tumor biomarkers could improve the sensitivity of lung cancer diagnosis （P 〈 0. 05 ）. Conclusion The serum TAP of lung cancer patients is obviously positive. The joint detection of TAP and CEA, NSE and Cyfra21-1 can improve the diagnostic rate of lung cancer.