CEA、CYFRA21-1、NSE、SCC联合检测对肺癌诊断及组织分型的应用研究

The application of combined detection with CEA,CYFRA21 1,NSE and SCC in lung cancer diagnosis and tissue typing

目的了解CEA、CYFRA21-1、NSE、SCC在健康居民、肺良性病变和肺癌患者体内含量的差异,分析该四项肿瘤指标用于肺癌联合诊断的可行性。方法回顾性分析2016年6月至2017年6月,相关科室收治的肺癌确诊患者135例、肺良性病变确诊患者120例、体检中心健康居民100例,比较不同对象CEA、CYFRA21-1、NSE、SCC含量的差异,分析肺癌组不同TNM分期和病理类型患者CEA、CYFRA21-1、NSE、SCC含量的差异及检测灵敏度,多因素回归分析的方法了解各因素对肺癌病理分型的影响。结果 3组患者CEA、CYFRA21-1、NSE、SCC含量差异均有统计学意义(P<0.05);健康对照组和肺良性病变组比较,NSE和SCC含量差异有统计学意义(P<0.05)。健康对照组与肺癌组比较,CEA、CYFRA21-1、NSE、SCC含量差异有统计学意义(P<0.05)。肺良性病变组和肺癌组比较,CEA、CYFRA21-1、NSE、SCC含量差异有统计学意义(P<0.05)。肺癌组135例患者不同TNM分期和病理分型对象CEA、CYFRA21-1、NSE、SCC含量差异均有统计学意义(P<0.05);腺癌患者检测灵敏度由高到低依次为CYFRA21-1、SCC、CEA、NSE;小细胞肺癌灵敏度由高到低依次为SCC、NSE、CYFRA21-1、CEA;鳞癌灵敏度由高到低依次为SCC、CEA、NSE、CYFRA21-1。4个肿瘤检测指标对肺癌病理分型影响力大小依次为NSE(OR=6.373)、6.373(OR=5.778)、CYFRA21-1(OR=5.709)、CEA(OR=5.104)。结论 CEA、CYFRA21-1、NSE、SCC在健康居民、肺良性病变和肺癌患者体内的表达差异明显,且在肺癌不同TNM分期和病理分型患者体内存在明显差异,利用该4项肿瘤检测指标用于肺癌组织分型的综合诊断有较高的临床使用价值。

Objective To investigate the differences of contents of caricinoembryonie antigen（ CEA）,cytokeratin 19 fragment antigen（ CYFRA21-1）,neuron-specific enolase（ NSE）,squamous cell carcinoma antigen（ SCC） in healthy people,lung benign tumor patients and lung cancer patients,and to analysis the feasibility of the four tumor markers in combination diagnosis of lung cancer. Methods A total of 135 patients with lung cancer who were admitted and treated in our hospital from June 2016 to June 2017,and 120 patients with benign lung lesion as welll as 120 healthy subjects were enrolled in the study,and related data were retrospectively analyzed. The differences of levels of CEA,CYFRA21-1,NSE and SCC were observed and compared among the three groups. Moreover the content differences of CEA,CYFRA21-1,NSE,SCC and detection sensitivity in diagnois of lung cancer in patients with different TNM stages and pathological types were observed and compared. The effects of different factors on the different pathological type of lung cancer were analysed by means of multiple factors regression analysis method. Results There were significant differences in the levels of CEA,CYFRA21-1,NSE and SCC among the three groups（ P〈0. 05）. Moreover there were significant differences in the levels of CEA,CYFRA21-1,NSE and SCC between healthy control group and benign lung lesion group（ P〈0. 05）. In addition there were significant differences in the levels of NSE and SCC between healty control group and lung cancer group（ P〈0. 05）,and there were significant differences in the levels of CEA,CYFRA21-1,NSE,SCC,between benign lung lesion group and lung cancer group（ P〈0. 05）. There were significant differences in the levels of CEA,CYFRA21-1,NSE,SCC in 135 lung cancer patients with different TNM stages and pathological type（ P〈0. 05）. The detection sensitivity in diagnosis of adenocarcinoma were CYFRA21-1,SCC,CEA and NSE in order（ from high to low）; the detection sensitivity in diagnosis of small cell lung cancer were SCC,NSE,CYFRA21-1,CEA in order; the detection sensitivity in diagnosis of squamous cell carcinoma were SCC,CEA,NSE,CYFRA21-1 in order. The influencing extent of four biochemical indexes on the pathological typing of lung cancer were NSE（ OR = 6. 373）,SCC（ OR = 5. 778）,CYFRA21-1（ OR = 5. 709）,CEA（ OR = 5. 104） in order.Conclusion There are significant differences in the expression levels of CEA,CYFRA21-1,NSE and SCC amonghealthy people,patients with benign lung lesion and patients with lung cancer,moreover,there are significant differences in the patients with different TNM stages and pathologic type of lung cancer. The four detection indexes have higher clinical diagnosis value in comprehensive diagnosis of lung cancer tissue typing.