支气管镜活检联合胸水肿瘤标志物检测对肺癌的诊断意义

Diagnostic Significance of Fiberoptic Bronchoscope Examination and Hydrothorax Tumor Marker Determination in Lung Cancer

目的探讨支气管镜活检联合胸水肿瘤标志物检测对肺癌的诊断价值。方法选择本院2015年7月至2016年12月收治的肺癌伴胸水患者42例及同期肺部良性病变患者28例,全部患者行电子支气管镜检查,并采用化学发光免疫分析法检测患者血清或胸水癌胚抗原(CEA)、糖链抗原125(CA125)、细胞角蛋白19片段21-1(CYFRA21-1)。分析支气管镜检查联合胸水肿瘤标志物检测诊断肺癌的敏感性、特异性、准确性。结果肺癌组患者血清CEA、CA125、CYFRA21-1水平明显高于良性病变组,差异均有统计学意义(P<0.05);在肺癌患者中,胸水CEA、CA125、CYFRA21-1水平明显高于血清(P<0.05),并且胸水CEA、CA125、CYFRA21-1诊断肺癌的敏感性高于血清(P<0.05)。支气管镜检查联合胸水CEA、CA125、CYFRA21-1检测诊断肺癌的敏感度及准确度明显高于单独支气管镜检查或单独肿瘤标志物检测,差异均有统计学意义(P<0.05)。结论支气管镜检查联合胸水肿瘤标志物检测可提高肺癌诊断率,值得应用。

Objective To explore diagnostic value of fiberoptic bronchoscope examination and hydrothorax tumor marker determination in lung cancer. Methods 42 patients with lung cancer and hydrothorax and 28 patients with benign lung disease in our hospital from July 2015 to December 2016 were selected, all patients were given fiberoptic bronchoscope examination, and chemiluminescence immunoassay was used to detect carcinoembryonic antigen（CEA）, carbohydrate antigen 125（CA125）, cytokeratin 19 fragment 21-1（CYFRA21-1） in serum and hydrothorax,then the sensitivity, specificity, accuracy of fiberoptic bronchoscope examination and hydrothorax tumor marker determination in diagnosis of lung cancer were analyzed. Results Serum CEA, CA125, CYFRA21-1 levels of patients with lung cancer were significantly higher than benign lung disease group, the differences were statistically significant（P〈0.05）; in patients with lung cancer, CEA, CA125, CYFRA21-1 levels of hydrothorax were significantly higher than serum（P〈0.05）, and sensitivity of hydrothorax CEA, CA125, CYFRA21-1 in diagnosis of lung cancer was higher than serum（P〈0.05）. Sensitivity and accuracy of bronchoscope examination and hydrothorax tumor marker determination in diagnosis of lung cancer was significantly higher than bronchoscopy or tumor marker determination separately, the differences were statistically significant（P〈0.05）. Conclusion Fiberoptic bronchoscope examination and hydrothorax tumor marker determination can increase the diagnosis rate of lung cancer, it is worthy of application.