血清CYfra21-1、LDH、NSE水平检测在肺癌患者辅助诊断中的应用

Application of serum CYfra21-1,LDH and NSE levels in the auxiliary diagnosis of lung cancer

目的探究血清细胞角蛋白19片段(CYfra21-1)、乳酸脱氢酶(LDH)、神经元特异性烯醇化酶(NSE)水平检测在肺癌患者辅助诊断中的应用。方法以2018年7月-2019年7月在河北北方学院附属第一医院心胸外科诊治的58例肺癌患者(肺癌组)和35例肺部良性病变患者(良性病变组)及35名同期健康体检者(健康组)为对象,检测各组血清CYfra21-1、LDH、NSE水平,ROC曲线分析CYfra21-1、LDH、NSE水平在肺癌诊断中的价值,同时分析不同病理特征肺癌患者血清CYfra21-1、LDH、NSE水平变化。结果肺癌组血清CYfra21-1、LDH、NSE水平显著高于肺部良性病变组、对照组,肺部良性病变组显著高于对照组,差异具均具有统计学意义(P<0.05);ROC曲线分析提示血清CYfra21-1、LDH、NSE联合检测诊断肺癌的曲线下面积、敏感度、特异度显著高于各指标单独检测,差异具有统计学意义(P<0.05)。TNM分期为Ⅲ、Ⅳ期、病理类型为鳞癌、分化程度为低分化、淋巴结有转移的肺癌患者CYfra21-1、LDH、NSE水平显著高于TNM分期为Ⅰ、Ⅱ期、病理类型为腺癌、分化程度为中、高分化的,差异具有统计学意义(P<0.05);Spearman相关性分析显示血清CYfra21-1、LDH、NSE水平与肺癌淋巴结转移率呈明显正相关(P<0.05)。结论肺癌患者血清CYfra21-1、LDH、NSE水平呈明显增高趋势,三者联合检测利于肺癌的早期诊断,且血清CYfra21-1、LDH、NSE水平与肺癌患者淋巴结转移风险密切相关。

Objective To investigate the application of serum cytokeratin 19 fragment(CYfra21-1),lactate dehydrogenase(LDH)and neuron-specific enolase(NSE)levels in the auxiliary diagnosis of lung cancer. Methods 58 patients with lung cancer(lung cancer group)and 35 patients with benign lung lesions(benign lesion group) who were diagnosed and treated in The First Affiliated Hospital of Hebei North University between July 2018 and July 2019 were selected as the subjects. 35 health people(health group)who completed health checkups in the hospital during the same period were also enrolled in the study. The serum CYfra21-1,LDH and NSE levels in each group were detected. The ROC curve was used to analyze the value of CYfra21-1,LDH and NSE levels in the diagnosis of lung cancer,and serum CYfra21-1,LDH and NSE levels in lung cancer patients with different pathological characteristics were analyzed. Results The serum CYfra21-1,LDH and NSE levels were significantly higher in the lung cancer group than in the benign lesion group and the control group,and the benign lung disease group was significantly higher than the control group,and the differences were statistically significant(P<0.05). ROC curve analysis showed that area under the curve,sensitivity and specificity of the combined detection of serum CYfra21-1,LDH and NSE in the diagnosis of lung cancer were significantly higher than those of the individual indicators(P<0.05). The serum CYfra21-1,LDH and NSE levels were significantly higher in lung cancer patients at TNM stageⅢ,with squamous,low differentiation and lymph node metastasis than the TNM stagesⅠandⅡstage,and pathological type adenocarcinoma(P<0.05). Spearman correlation analysis showed that serum CYfra21-1,LDH and NSE levels were significantly positively correlated with lymph node metastasis rate of lung cancer(P<0.05). Conclusion Serum CYfra21-1,LDH and NSE levels are significantly higher in patients with lung cancer. The combined detection of the three is beneficial for the early diagnosis of lung cancer,and serum CYfra21-1,LDH,and NSE levels are closely related to the risk of lymph node metastasis in lung cancer patients.