血清CEA、CYFRA21-1、NSE、SCCA、PROGRP联合检测诊断肺癌的临床意义

Clinical significance of combined detection of serum CEA,CYFRA21-1,NSE,SCCA and PROGRP

目的探讨肿瘤标志物——癌胚抗原(CEA)、细胞角蛋白19片段21-1(CYFRA21-1)、神经元特异性烯醇化酶(NSE)、鳞状细胞癌抗原(SCCA)及胃泌素释放肽前体(PROGRP)联合检测在肺癌诊断中的价值。方法选取2015年1月至2018年6月该院收治的肺癌患者300例作为肺癌组,选取同期入院的肺良性疾病患者90例作为对照组,采用电化学发光免疫法测定2组血清CEA、CYFRA21-1、NSE、SCCA、PROGRP水平,对比不同病理类型肺癌患者5种肿瘤标志物水平的差异,比较肿瘤标志物单项及联合检测诊断肺癌效能的差异。结果肺癌组患者5种肿瘤标志物水平均明显高于对照组,差异均有统计学意义(P<0.05)。肺腺癌组患者CEA水平较高,肺鳞癌患者CYFRA21-1、SCCA水平均较高,肺小细胞肺癌组患者NSE、PROGRP水平均显著升高。血清肿瘤标志物联合检测诊断肺癌的灵敏度明显高于单项检测。结论单项肿瘤标志物检测存在一定的局限性,诊断不同类型肺癌的灵敏度具有较大差异,联合检测能有效提高诊断肺癌的灵敏度,对肺癌的诊断具有重要的参考价值。

Objective To investigate the clinical value of combined detection of carcinoembryonic antigen(CEA),cytokeratin 19 fragment 21-1(CYFRA21-1),neuron-specific enolase(NSE),squamous cell carcinoma antigen(SCCA)and gastrin-releasing peptide precursor(PROGRP)in the diagnosis and pathology of lung cancer.Methods A total of 120 cases of lung cancer patients admitted to the hospital from January 2015 to June 2018 were selected as the lung cancer group.A total of 90 patients with benign lung disease admitted to our hospital during the same period were as the control group.Serum CEA,CYFRA21-1,NSE,SCCA and PROGRP levels of the two groups were measured.The levels of five tumor markers in different pathological types of lung cancer were compared,and the tumor markers were compared.The difference of diagnostic efficacy between single and combined biopsy in lung cancer.Results There were significant differences in the five tumor markers between lung cancer group and control group(P<0.05),which was significantly higher than that of control group.CEA was higher in lung adenocarcinoma group,CYFRA21-1 and SCCA were higher in lung squamous cell carcinoma,NSE and PROGRP were higher in lung small cell lung cancer.The sensitivity,specificity and accuracy of combined detection of serum tumor markers were higher than those of single detection.Conclusion There are some limitations in the detection of single tumor markers.The sensitivity and specificity of different types of lung cancer are quite different.Combined detection can effectively improve the sensitivity,specificity and accuracy of lung cancer detection.It has important reference value for the diagnosis of lung cancer.