多种血清肿瘤标志物联合检测诊断非小细胞肺癌的价值研究

The value of multiple serum tumor markers in diagnosis of non-small cell lung cancer

目的:探究多种血清肿瘤标志物联合检测诊断非小细胞肺癌(Non-small Cell Lung Cancer,NSCLC)的价值。方法:2015年1月-2019年1月,在佛山市禅城区中心医院接受治疗的NSCLC患者中选取100例为观察组。选取良性肺部病变者100例命名肺良性病变组,包括肺气肿、肺结核、肺炎、肺纤维瘤等。对照组为体检健康者共计100例。对三组CA199、CA125、CYFRA211、CEA、NSE水平进行观察,对上述标志物阴性预测值、阳性预测值、特异性、灵敏度应用联合检测和单一检测加以分析,以及分期不同和预后时间不同的肿瘤标志物水平的差异对比。结果:糖类抗原199(Carbohydrate Antigen 199,CA199)、糖类抗原125(Carbohydrate Antigen 125,CA125)、CYFRA211、癌胚抗原(Carcino-embryonic Antigen,CEA)、神经元特异性烯醇化酶(Neuron Specific Enolase,NSE)水平对比,观察组较对照组和肺良性病变组高,对比差异存在统计学意义(P <0.05)。检测单一指标显示,阳性预测值和特异性最高的是NSE,阴性预测值和灵敏度最高的是CYFRA211;阳性预测值和灵敏度联合检测指标较单一检测高。对比CA199、CA125、CYFRA211、CEA、NSE水平,NSCLC患者Ⅲ~Ⅳ期较Ⅰ~Ⅱ期高,对比存在差异(P <0.05)。结论:联合检测CA199、CA125、CYFRA211、CEA、NSE水平对于早期诊断NSCLC,以及疾病的分期和预后等方面提供依据。

Objective:To explore the value of multiple serum tumor markers in diagnosis of non-small cell lung cancer.Methods:From January 2015 to January 2019,100 NSCLC patients receiving treatment in Foshan Chancheng Central Hospital were selected as the observation group.A total of 100 patients with benign lung lesions were selected and named as the group of benign lung lesions,including emphysema,pulmonary tuberculosis,pneumonia and pulmonary fibroma.The control group consisted of 100 healthy patients.The levels of CA199,CA125,CYFRA211,CEA,and NSE in three groups were observed,and the negative predictive value,positive predictive value,specificity,and sensitivity of the above markers were analyzed by combination test and single test,as well as the differences in the levels of tumor markers with different stages and prognosis time.Results:The levels of CA199,CA125,CYFRA211,CEA,and NSE in the observation group were higher than those in the control group and the lung benign lesion group,which was with differences(P<0.05).The single test index showed that NSE had the highest positive predictive value and specificity,while CYFRA211 had the highest negative predictive value and sensitivity.The combination of positive predictive value and sensitivity was higher than the single test.Contrast CA199,CA125,CYFRA211,CEA,NSE levels,patients with NSCLC III-IV period were higher than patients with NSCLC I–II period,which was with high contrast differences(P<0.05).Conclusion:Combined detection of CA199,CA125,CYFRA211,CEA,and NSE levels provides evidence for early diagnosis of NSCLC,as well as disease staging and prognosis.