血清PCT、NSE和CEA联合检测对小细胞肺癌的诊断价值

Clinical diagnostic value of combined detection of serum PCT,NSE and CEA in small cell lung cancer

目的探讨降钙素原(PCT)、神经元特异性烯醇化酶(NSE)和癌胚抗原(CEA)三项血清学标志物检测在小细胞肺癌诊断中的临床价值.方法将2016年1月至2017年12月郑州大学第一附属医院呼吸科收治的142例排除肺部感染及其他感染史新确诊的肺癌住院患者,分为小细胞癌组(n=47)、腺癌组(n=45)、鳞癌组(n=50),另选择同期体检的健康者作为对照组(n=40),检测各组PCT、NSE和CEA血清学指标并进行分析.结果小细胞癌组与腺癌组和鳞癌组PCT、NSE、CEA水平比较差异均有统计学意义(P均<0.01).小细胞癌组PCT、NSE阳性率高于其他三组(P<0.05).PCT、NSE、CEA区分小细胞肺癌和鳞癌、腺癌的鉴别诊断PCT的最佳截断点分别为0.115、16.56、3.71ng/ml,受试者工作特征曲线下面积分别为0.763、0.889、0.646,PCT、NSE、CEA的敏感性分别为61.7%、77.9%、59.6%,特异性分别为80.0%、87.2%、73.7%;联合检测PCT+NSE+CEA可以将敏感性提高至89.4%,特异性提高至88.6%,准确度提高至92.0%.结论与PCT、NSE、CEA中任意一项或两项标志物检测比较,联合CEA、PCT和NSE三项标志物检测有助于小细胞肺癌的诊断和病理分型.

Objective To investigate the clinical value of procalcitonin(PCT),neuron-specific enolase(NSE)and carcinoembryonic antigen(CEA)in the diagnosis of small cell lung cancer.Methods From January 2016 to December 2017,142 lung cancer patients admitted to the Respiratory Department of the First Affiliated Hospital of Zhengzhou University were excluded from lung infection and other newly diagnosed lung cancer patients,they were divided into 3 groups:small cell carcinoma group(n=47),adenocarcinoma group(n=45)and squamous cell carcinoma group(n=50).And healthy subjects who underwent physical examination at the same time were selected as the control group(n=40).Three serum markers including PCT,NSE and CEA were detected and analyzed among each group.Results PCT,NSE,CEA levels were significantly different in the small cell carcinoma group,the adenocarcinoma group and the squamous cell carcinoma group(P all<0.01).The PCT positive rate and NSE positive rate of small cell carcinoma group were significantly higher than those of other groups(P<0.05).The best cut-off points of PCT,NSE and CEA for the differential diagnosis of small cell lung cancer,squamous cell carcinoma and adenocarcinoma were 0.115 ng/ml,16.56 ng/ml and 3.71 ng/ml,respectively.The values area under the receiver operating characteristic curve were 0.763,0.889 and 0.646.The sensitivity values of PCT,NSE and CEA were 61.7%,77.9%and 59.6%.The specificity values were 80.0%,87.2%and 73.7%.Combined detection of PCT,NSE and CEA increased the sensitivity to 89.4%,specificity to 88.6%,and accuracy to 92.0%.Conclusions Compared with the detection of any one or two markers in PCT,NSE and CEA,combined detection of CEA,PCT and NSE markers can contribute to the diagnosis and pathological typing of small cell lung cancer.