血清肿瘤标志物和凝血指标联合检测在肺癌辅助诊断中的应用

Combined Detection of Serum Tumor Markers and Coagulation Indicators in Lung Cancer Auxiliary Diagnosis

目的:探讨常见凝血指标和肿瘤标志物联合检测在肺癌辅助诊断中的应用价值。方法:采用回顾性研究方法收集2018年11月1日至2019年11月1日在佳木斯大学附属第一医院就诊并明确诊断的肺癌患者41例作为肺癌组。选取同时段良性疾病46例作为对照组。分析两组的纤维蛋白原(fibrinogen,FIB)、血小板(plateletcount,PLT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶原时间(prothrombin time,PT)、凝血活酶时间(thromboplastin time,TT),血清中神经元特异性烯醇化酶(Neuron-specific enolase,NSE)、细胞角蛋白19(Cytokeratin fragment 21,CYFRA21-1)和癌胚抗原(Carcinoembryonic antigen,CEA)的含量。结果:肺癌组的凝血指标均高于良性疾病组,其中两组的PT值差异具有统计学意义(p=0.04)。CYFRA21-1诊断肺癌的特异性最高(特异性=0.915),CEA诊断肺癌的灵敏度最好(灵敏度=0.805)。CYFRA21-1+FIB+PT+TT联合检测对肺癌诊断的灵敏度,特异性和约登指数分别为80.49%,80.43%,0.609。灵敏度,特异性和约登指数均优于单项肿瘤标志物的检测。结论:凝血指标和肿瘤标志物对肺癌的辅助诊断都具有价值,联合检测更能提高诊断的灵敏度和特异性,为肺癌的早期诊断提供价值。

Objective: To explore the value of combined detection of common coagulation indicators and tumor markers in the auxiliary diagnosis of lung cancer. Methods: A retrospective study was performed to collect 41 patients with lung cancer who had been diagnosed and diagnosed at the First Affiliated Hospital of Jiamusi University from November 1, 2018 to November 1, 2019 as the lung cancer group. Forty-six patients with benign disease at the same period were selected as the control group. Analyze fibrinogen(FIB), platelet count(PLT), activated partial thromboplastin time(APTT), prothrombin time(PT), and thromboplastin time in both groups(thromboplastin time, TT), serum levels of neuron-specific enolase(NSE), cytokeratin 19(Cytokeratin fragment 21, CYFRA21-1), and carcinoembryonic antigen(CEA) content. Results: The coagulation index of lung cancer group was higher than that of benign disease group, and the difference in PT value between the two groups was statistically significant(p = 0.04). CYFRA21-1 has the highest specificity for the diagnosis of lung cancer(specificity = 0.915), and CEA has the best sensitivity for the diagnosis of lung cancer(sensitivity = 0.805). The sensitivity, specificity, and Jordan index of the combined detection of CYFRA21-1 + FIB + PT + TT for lung cancer diagnosis were 80.49 %, 80.43 %, and 0.609. Sensitivity, specificity, and Yoden index are better than the detection of a single tumor marker. Conclusion: Coagulation indicators and tumor markers are valuable for the auxiliary diagnosis of lung cancer. Combined detection can improve the sensitivity and specificity of diagnosis, and provide value for the early diagnosis of lung cancer.