NSE、SCC-Ag、CEA、CYFRA21-1联合凝血指标检测在肺癌诊断中的应用价值

Diagnostic value of NSE, SCC-Ag, CEA and CYFRA21-1 combined with coagulation parameters for lung cancer

目的探讨血清肿瘤标志物神经元特异性烯醇化酶(NSE)、鳞状细胞癌抗原(SCC-Ag)、癌胚抗原(CEA)、细胞角质蛋白19片段抗原21-1(CYFRA21-1)联合血小板、D-二聚体、纤维蛋白原等凝血指标检测在肺癌诊断中的应用价值。方法将80例肺癌患者、80例肺良性疾病患者、80例健康体检者分别设为肺癌组、肺良性疾病组和健康对照组,检测3组研究对象及不同病理类型肺癌患者的NSE、SCC-Ag、CEA、CYFRA21-1水平,并比较肺癌患者治疗前、中、后血小板、D-二聚体、纤维蛋白原水平。结果肺癌组患者NSE、SCC-Ag、CEA、CYFRA21-1水平均高于肺良性疾病组和健康对照组,差异均有统计学意义(P﹤0.05)。小细胞肺癌(SCLC)患者NSE水平高于鳞状细胞癌及腺癌患者且CYFRA21-1水平低于鳞状细胞癌及腺癌患者,鳞状细胞癌患者SCC-Ag水平高于腺癌及SCLC患者,腺癌患者CEA水平高于鳞状细胞癌及SCLC患者,差异均有统计学意义(P﹤0.05)。CYFRA21-1诊断肺癌的灵敏度相对较高,NSE诊断肺癌的特异度、准确度、阳性预测值及阴性预测值均相对较高。治疗中及治疗后肺癌组患者血小板计数、D-二聚体、纤维蛋白原水平均低于治疗前,差异均有统计学意义(P﹤0.05)。结论肺癌患者血清中肿瘤标志物NSE、SCC-Ag、CEA、CYFRA21-1联合凝血指标变化有利于肺癌的早期诊断,值得进一步深入研究。

Objective To explore the value of serum tumor markers neuron specific enolase(NSE),squamous cell carcinoma antigen(SCC-Ag),carcinoembryonic antigen(CEA),cyto-keratin 19 fragment antigen 21-1(CYFRA21-1)combined with coagulation parameters of platelet count,D-dimer,and fibrinogen in the diagnosis of of lung cancer.Method Eighty patients with lung cancer,80 patients with benign lung disease,and 80 healthy subjects were included in the study as lung cancer group,lung benign disease group and healthy control group,respectively.The levels of NSE,SCC-Ag,CEA,and CYFRA21-1 in these three groups and in different pathological lesions were measured,besides,the levels of coagulation parameters such as platelet count,D-dimer,and fibrinogen before,during,and after treatment were detected.Result The levels of NSE,SCC-Ag,CEA and CYFRA21-1 in lung cancer group patients were significantly higher than those in lung benign disease group and healthy control group(P<0.05).Patients with small cell lung cancer(SCLC)had significantly higher NSE and lower CYFRA21-1 compared to those with squamous cell carcinoma(SCC)and adenocarcinoma patients,while the SCC-Ag in SCC patients was higher than that in adenocarcinoma and SCLC patients,CEA was significantly higher in adenocarcinoma patients compared to SCC and SCLC patients,with statistically significant differences observed(P<0.05).CYFRA21-1 had high sensitivity for the diagnosis of lung cancer,and NSE had relatively high specificity,accuracy,positive predictive value and negative predictive value in diagnosis.During and after treatment,the platelet count,D-dimer and fibrinogen were decreased comparing with those before treatment,and the differences were of statistical significance(P<0.05).Conclusion The changes of tumor markers such as NSE,SCC-Ag,CEA and CYFRA21-1 in combination with coagulation parameters in patients with lung cancer are helpful to achieve the early diagnosis of the disease,which deserves further investigation.