ECT与CEA、NSE、CYFRA21-1联合检测在老年肺癌骨转移诊断中的价值

Clinical value of ECT,NSE and CYFRA21-1 joint detection in the diagnosis of lung cancer bone metastasis in elderly patients

目的探讨放射性核素骨显像(ECT)与肿瘤标志物癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)和细胞角蛋白19的可溶性片段(CYFRA21-1)联合检测在老年肺癌骨转移诊断中的价值。方法随机选取69例老年肺癌患者作为研究组,另选取同期收治的44例肺部良性疾病患者作为对照组。对两组患者进行ECT检查,并运用放射性免疫检测技术检测其血清CEA、NSE和CYFRA21-1水平。结果研究组中骨转移患者的ECT骨显像阳性率、血清CEA、CYFRA21-1水平均显著高于未转移患者,差异有统计学意义(P<0.05),骨转移和未转移患者的ECT骨显像阳性率、血清CEA、NSE、CYFRA21-1水平均显著高于对照组,差异有统计学意义(P<0.05)。ECT+CEA+NSE+CYFRA21-1在老年肺癌骨转移诊断中的敏感性、特异性、准确性均显著高于ECT、CEA+NSE+CYFRA21-1,差异有统计学意义(P<0.05)。结论 ECT与肿瘤标志物CEA、NSE和CYFRA21-1联合检测在老年肺癌骨转移诊断中具有较高的临床价值。

Objective To investigate the clinical value of emission computed tomography （ECT） and tumor markers eareinoembryonie antigen （CEA）, neuron-specific enolase （NSE） and soluble fragments of cytokeratin 19 （CYFRA21- 1 ） joint detection in the diagnosis of lung cancer bone metastasis in elderly patients. Methods 69 cases of elderly patients with lung cancer who were treated in our hospital from May 2014 to May 2016 were randomly selected ; these patients were regarded as study group. Another 44 eases of benign lung disease patients treated in our hospital in the same period were selected as control group; the two groups were given ECT check, and the serum CEA, NSE and CYFRA21-1 levels were measured by radioimmunoassay techniques. Results The positive rate of ECT bone imaging, serum CEA and CYFRA21-1 levels of patients with bone metastases in the study group were significantly higher than those in patients without metastasis （P〈0.05）. The ECT bone imaging, serum CEA, NSE and CYFRA21-1 levels of patients with and without bone metastases in the study group were significantly higher than those of the control group （P〈0.05）. The sensitivity, specificity and accuracy of ECT＋ CEA ＋ NSE ＋ CYFRA21 - 1 in the diagnosis of lung cancer bone metastasis in elderly patients were significantly higher than those of using ECT alone, or CEA＋NSE＋CYFRA21-1 （P〈0.05）. Conclusion The clinical value of ECT and tumor markers CEA, NSE and CYFRA21-1 joint detection in the diagnosis of lung cancer bone metastasis in elderly patients was better than using ETC alone or CEA＋NSE＋CYFRA21-1.