肿瘤标志物和炎症指标在肺癌诊断和预后中的价值分析

Value of tumor markers and inflammation indicators in the diagnosis and prognosis of lung cancer

目的 探讨肿瘤标志物和炎症指标在肺癌诊断和预后中的价值。方法 回顾性分析2006年-2017年温州医科大学附属第一医院收治的肺癌患者,收集其肿瘤标志物和炎症指标,并以健康体检者为对照组,根据预后分为死亡组和未死亡组,把肺癌死亡组按生存时间分为2组(<12个月组和≥12个月组);将各组数据进行比较并分析。结果 肺癌组CEA、CA19-9、SCCA、CYFRA21-1、NSE、CRP、NLR、PLR均明显高于对照组,LMR小于对照组,差异均有统计学意义(P <0. 05)。肺癌死亡组的SCCA、NSE、CRP、NLR明显高于肺癌未死亡组,差异均有统计学意义(P <0. 05)。Logistic回归分析显示CEA、CYFRA21-1、NSE、CRP是肺癌发生危险因素;肺癌死亡组中,生存时间<12个月组的男性比例、CYFRA21-1、NSE、CRP、NLR、PLR明显高于生存时间≥12个月组,而LMR明显低于生存时间≥12个月组,差异均有统计学意义(P <0. 05);Spearman相关分析显示生存时间与CYFRA21-1、NSE、CRP、NLR、PLR呈负相关,与LMR呈正相关(P <0. 05)。ROC检测显示联合诊断的效能明显优于单项检测。结论 肿瘤标志物(CEA、CA19-9、SCCA、CYFRA21-1、NSE)和炎症指标(CRP、NLR、LMR、PLR)在肺癌诊断和预后中具有一定的价值,联合检测可以增加肺癌诊断的敏感性和特异性。

Objective To investigate the value of tumor markers and inflammatory markers in the diagnovsis and prognosis of lung cancer.Methods A retrospective analysis was conducted on patients with lung cancer from the First Affiliated Hospital of Wenzhou Medical University from 2006 to 2017,and tumor markers and inflammatory markers were collected.The health checkup population was collected as the control group.The death group and non-death group were divided according to the prognosis.T'he patients were divided into death group and non-death group according to prognosis(<1 year and≥1 year);the data of the groups were compared iind analyzed.Results The CEA,CA19-9,SCCA,CYFRA21-1,NSE,CRP,NLR and PLH of lung cancer group were significantly higher than those of the control group,LMR was significantly lower than that of the control group,with the differences statistically significant(P<0.05).SCCA,NSE,CRP and NLR in death group were significantly higher than those in non—death group,with the differences statistically significant(P<0.05).Logistic regression analysis showed that CEA,CYFRA21-1,NSE1 and CRP were risk factors for lung cancer.Among the death group,the proportion of males,CYFHA21-1,NSE,CRP,NLR and PLR in survival<12 months group were significantly higher than those in patients with survival≥12 months group,while LMR was significantly lower than the survival time of,12 months group;Spearman correlation analysis showeid that the survival time was negatively correlated with CYFRA21-1,NSE,CRP,NLR and PLFi,and positively correlated with LMR(P<0.05).ROC test showed that the efficiency of combined diagnosis was significantly hotter than that of single detection.Conclusion The tumor markers(C E A,CA19-9,SCCA,CYFRA21-1,NSE)and inflammatory markers(C liP,NLR,LMR and PLR)are of value in the diagnosis and prognosis of lung cancer.Combined detection can increase the sensitivity of lung cancer diagnosis and specificity.