血清肿瘤标志物单独或联合检测在原发性肺癌中的诊断价值

Comparison of clinical effects between single or combined detection of serum tumor markers in patients with primary lung cancer

目的探索血清肿瘤标志物单独或联合检测在原发性肺癌中的诊断价值。方法选取2013年6月至2015年6月该院接受治疗的86例患者为研究对象,其中44例初步确诊肺癌的患者为观察组,其余42例患有良性肺疾病的患者为对照组。研究过程中对患者的血清进行血清神经元特异性烯醇化酶(NSE)、糖类癌抗原199(CA199)、细胞角蛋白21片段抗原(Cyfra21-1)及癌胚抗原(CEA)等肺癌标志物的检测,对4项指标进行阳性率计算及统计学比较。此外,对4项肺癌标志物进行单独或联合检测的灵敏度、准确度、特异度对比。结果研究发现,在原发性肺癌指标的评价标准下,观察组患者的NSE、CA199、Cyfra21-1、CEA 4项指标水平均高于对照组,差异有统计学意义(P<0.05)。两组患者NSE、CA199、Cyfra21-1、CEA阳性率比较,Cyfra21-1阳性率最高,CA199和CEA次之,NSE阳性率最低;对照组NSE、CA199、Cyfra21-1、CEA阳性率均低于观察组,差异有统计学意义(P<0.05)。在肺癌标志物单独比较中,Cyfra21-1的准确度及特异度最高,但联合检测的灵敏度、准确度及特异度程度评分大致是Cyfra21-1的2倍。结论血清肿瘤标志物联合检测在原发性肺癌诊断中具有较高的灵敏度和准确度,适用于临床推广。

Objective To explore the clinical value of single or combined detection of serum tumor markers in the patients with primary lung cancer. Methods Eighty-six patients receiving treatment in our hospital from June 2013 to June 2015 were selected as the study subjects,in which 44 cases of preliminarily diagnosed primary lung cancer served as the observation group and the other 42 cases of benign lung diseases were taken as the control group. During the study, the lung cancer markers of serum neuron specific enzyme（NSE）, carbohydrate antigen 199 （CA199）, cytokeratin 21 fragment antigen （Cyfra21-1） and carcinoembryonic antigen （CEA） were detected. The positive rates of 4-item indexes were calculated and performed the statistical comparison. In addition, the sensitivity,accuracy and specificity were compared between single index and 4-index combined detections. Results The study found that in the evaluation standard of primary lung cancer, the levels of NSE, CA199, Cyfra21-1and CEA in the observation group were higher than those in the control group, the difference was statistically significant（P〈0.05）. In the comparison of positive rates in 4 lung cancer markers,the positive rate of Cyfra21-1 was highest,followed by CA199 and CEA,which of NSE was lowest,the levels of NSE, CA199, Cyfra21-1 and CEA in the control group were lower than those in the observation group, the difference was statisti- cally significant（P〈0.05）. In the comparison of single lung cancer marker, the accuracy and specificity of Cyfra21-1 were highest, but which in the combined lung cancer markers detection were roughly twice of Cyfra21-1. Conclusion The combination detection of serum tumor markers in the patients with primary lung cancer has significant sensitivity and accuracy,and is suitable for clinical promotion.