不同病理类型肺癌早期诊断中血清标志物联合检测的应用分析

Application of Combined Detection of Serum Markers in Early Diagnosis of Lung Cancer with Different Pathological Types

目的探讨血清多项指标联合检测在不同病理类型肺癌诊断中的应用价值。方法比较检测指标单项检查与联合检查在不同类型肺癌中的敏感性和特异性。结果本研究采用的检测指标为癌胚抗原(CEA)、神经原特异烯醇化酶(NSE)、细胞角蛋白19片断(CYFRA21-1)、胃泌素释放肽前体(ProGRP)、鳞状细胞癌相关抗原(SCC)等5种。在小细胞肺癌的诊断中,CEA+NSE+ProGRP方案的敏感性和特异性分别为90.0%和92.1%,明显高于大细胞肺癌的的敏感性和特异性;在鳞癌的诊断中,CEA+CYFRA21-1+SCC敏感性和特异性分别为91.1%和93.6%,明显高于小细胞肺癌和腺癌的敏感性和特异性;CEA+NSE+CYFRA21-1对各种类型肺癌的诊断具有良好的敏感性和特异性,可用于肺癌筛查。结论联合检测过多肿瘤标志物增加了患者的经济负担,对肺癌的早期诊断的敏感性和特异性无明显影响,不推荐使用。

Objective To explore the value of combined detection of multiple serum markers in the diagnosis of different patholog. ical types of lung cancer. Methods The sensitivity and specificity of single examination and combined examination in different types of lung cancer were compared. Results In the study, five kinds of carcinoembryonic antigen(CEA), neurogen-specific enolase (NSE), keratin 19 fragment(CYFRA21-1),gastrin-releasing peptide(ProGRP)and squamous cell carcinoma-associated antigen (SCC)were detected.Sensitivity and specificity of,CEA+NSE+ProGRP regimen in the diagnosis of small cell lung cancer were 90.0% and 92.1% respectively,which were significantly higher than those of large cell lung cancer. In the diagnosis of squamous cell carcino. ma,the sensitivity and specificity of CEA+CYFRA21-1+SCC were 91.1% and 93.66%,respectively,which were significantly high. er than those of small cell lung cancer and adenocarcinoma. CEA+NSE CYFRA21-1has good sensitivity and specificity in the diagno. sis of various types of lung cancer, and can be used for lung cancer screening.Conclusion Combined detection of too many tumor markers increases the economic burden of patients,and has no significant impact on the sensitivity and specificity of early diagnosis of lung cancer. It is not recommended to be used.