五项肿瘤标志物联合检测在肺癌诊断中的价值

The value of combined detection of five tumor markers in the diagnosis of lung cancer

目的:探讨血清肿瘤标志物联合检测在肺癌诊断中的价值。方法:分别检测肺癌组(122例)、慢性阻塞性肺疾病组(123例)、正常对照组(100例)血清肿瘤标志物血清癌胚抗原(CEA)、糖类抗原724(CA724)、糖类抗原153(CA153)、糖类抗原242(CA242)、细胞角蛋白19片段抗原(CYFRA21-1)水平,分析五项血清肿瘤标志物的阳性率。利用ROC曲线分析单独及联合检测诊断肺癌的灵敏度、特异度,并综合评价五项肿瘤标志物对肺癌诊断的临床价值。结果:肺癌组血清肿瘤标志物(CEA、CA724、CA153、CA242、CYFRA21-1)浓度明显高于正常对照组及慢性阻塞性肺疾病组,差异有统计学意义(P<0.05);肺癌组血清CEA、CA724、CA153、CA242、CYFRA21-1阳性率较慢性阻塞性肺疾病组显著升高,差异有统计学意义(P<0.05);CEA、CA153、CYFRA21-1三项联合检测灵敏度、特异度分别为73.77%、64.22%,ROC曲线下的面积(AUCROC)为0.690,较单项检测有较高灵敏度,差异有统计学意义(P<0.05)。结论:CEA、CA724、CA153、CA242、CYFRA21-1对肺癌的早期诊断及疗效观察具有重要的临床意义。联合检测血清肿瘤标志物对于提高肺癌早期诊断的灵敏度以及特异度具有重要意义,可有效减少临床肺癌诊断的漏诊与误诊。

Objective：To investigate the clinical value of combined detection of serum tumor markers in the diagnosis of lung cancer.Methods：To test 122 cases of patients with lung cancer and 123 cases of patients with chronic obstructive pneumonia and 100 cases of healthy physical examination with serum levels of serum carcinoembryonic antigen（CEA）,sugar antigen724（CA724）,sugar antigen 153（CA153）,sugar antigen 242（CA242） and Cytokeratin-19-fragmen（CYFRA21-1）.To analyze the positive rate of five serum tumor markers in lung cancer group and chronic obstructive pulmonary group,and to analyze the sensitivity and specificity of diagnosis and diagnosis of lung cancer by ROC curve,and to evaluate the clinical value of five tumor markers for the diagnosis of lung cancer.Results：The level of serum tumor markers in lung cancer group was significantly higher than that in normal control group and chronic obstructive pulmonary group,and the difference was statistically significant （ P 〈0.05）.The positive rates of serum CEA,CA724,CA153,CA242 and CYFRA21-1 in lung cancer group were significantly higher than those in chronic obstructive pulmonary group （ P 〈0.05）.The sensitivity and specificity of combined detection of three serum tumor markers were 73.77%,64.22%,which were higher than those of single detection （ P 〈0.05）.Conclusion：CEA,CA724,CA153,CA242,CYFRA21-1 have important clinical significance in the early diagnosis and therapeutic effect of lung cancer.Tumor marker combination test can effectively improve the sensitivity and specificity of diagnosis of lung cancer patients,reduce the clinical misdiagnosis.