肺癌患者中HE4等六项肿瘤标志物的联合诊断价值探讨

The value of combined diagnosis of six tumor markers including HE4 in lung cancer patients

目的:探讨血清人附睾分泌蛋白4(HE4)、癌胚抗原(CEA)、糖类抗原125(CA125)、神经原特异性烯醇化酶(NSE)、细胞角蛋白-19片段(CYFRA21-1)、鳞状细胞癌相关抗原(SCC)在肺癌诊断及淋巴结转移监测中的意义。方法:选取肺癌患者85例,肺部良性病变患者45例,采用化学发光法检测其血清HE4、NSE、CEA、CA125、SCC、CYFRA21-1,比较其单独和联合使用时对肺癌的诊断价值。结果:肺癌组和对照组的血清HE4、NSE、CYRA21-1水平差异具有统计学意义(P<0.05),且当三者截断值分别为109.6 pmol/L、51.3 pmol/L和23.75 ng/mL时,其肺癌淋巴结转移的预测价值最佳。另外,六个项目联合检测的敏感性、准确性和阴性预测值高于各单项检测(P<0.05)。结论:联合检测血清HE4、CEA、CA125、SCC、NSE、CYFRA21-1对肺癌诊断及淋巴结转移的监测有重要诊断价值。

Objective:To investigate serum human epididymal secretory protein 4(HE4),carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),neuron-specific enolase(NSE),cytokeratin-19 fragment(CYFRA21-1),Significance of squamous cell carcinoma-associated antigen(SCC)in diagnosis of lung cancer and monitoring of lymph node metastasis.Methods:Eighty-five patients with lung cancer and 45 patients with benign lung disease were selected.The serum HE4,NSE,CEA,CA125,SCC,and CYFRA21-1 were detected by chemiluminescence,and the diagnostic value of lung cancer when used alone or in combination was compared.Results:There were significant differences in serum HE4,NSE,and CYFRA21-1 levels between the lung cancer group and the control group(P<0.05),and the cutoff values of the three were 109.6 pmol/L,51.3 pmol/L,and 23.75 ng/mL,respectively.At this time,the predictive value of lung cancer lymph node metastasis is the best.In addition,the sensitivity,accuracy,and negative predictive value of the six-item combined test were higher than those of the individual tests(P<0.05).Conclusion:The combined detection of serum HE4,CEA,CA125,SCC,NSE,and CYFRA21-1 has important diagnostic value for the diagnosis of lung cancer and the monitoring of lymph node metastasis.