神经元特异性烯醇化酶联合检测对肺癌诊断的价值分析

Diagnostic significance of neuron specific enolase combined detection for lung cancer

目的探讨神经元特异性烯醇化酶(NSE)、癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)和胃泌素释放肽前体(Pro GRP)检测对肺癌诊断的应用价值。方法选取2018年1月至2019年12月间辽宁省肿瘤医院收治的120例肺癌患者作为肺癌组,同期选取50例肺部良性疾病患者作为良性组,并将同期常规体检的100名健康者作为正常对照组。检测所有研究对象NSE、CEA、CYFRA21-1以及Pro GRP指标,比较肺癌组、正常对照组、良性组以及不同病理类型肿瘤标志物血清水平和不同肿瘤标志物对肺癌检测阳性率、敏感性和特异性。结果肺癌组NSE、CEA、CYFRA21-1以及Pro GRP水平均高于正常对照组与良性组,差异均有统计学意义(均P <0.05)。腺癌组、鳞癌组和小细胞肺癌组NSE、CEA、CYFRA21-1和Pro GRP检出阳性率均高于良性组,差异均有统计学意义(均P <0.05)。Ⅲ~Ⅳ期肺癌患者NSE、CEA、CYFRA21-1和Pro GRP水平均高于Ⅰ~Ⅱ期患者,差异均有统计学意义(均P <0.05)。NSE、CEA、CYFRA21-1和Pro GRP 4项指标联合诊断腺癌、鳞癌和小细胞肺癌敏感性分别为85.4%、86.9%、94.4%,特异度为60.7%,高于单一指标诊断,差异均有统计学意义(均P <0.05)。结论 NSE联合肿瘤标志物CEA、CYFRA21-1以及Pro GRP对肺癌有着较高的敏感性、特异性,对早期肺癌有较高的临床诊断价值,能够为临床治疗提供可靠参考。

Objective To explore the diagnostic value of neuron specific enolase( NSE) combined with carcinoembryonic antigen( CEA),cytokeratin 19( CYFRA21-1) and gastrin releasing peptide precursor( Pro GRP) for the diagnosis of lung cancer. Method From January 2018 to December 2019,120 lung cancer patients admitted to Liaoning Cancer Hospital were selected as the lung cancer group,50 benign lung disease patients as the benign group,and 100 healthy people who had routine physical examination at the hospital during the same time were selected as the normal control group. NSE,CEA,CYFRA21-1 and ProGRP indices of all subjects were detected and compared among the three groups. Serum levels of tumor markers of different pathological types were compared among the three groups. Positive rate,sensitivity and specificity of different tumor markers for lung cancer detection were also compared. Result The levels of NSE,CEA,CYFRA21-1 and Pro GRP were significantly higher in the lung cancer group than those in the normal control group and the benign group( all P < 0. 05). The positive rates of NSE,CEA,CYFRA21-1 and Pro GRP were significantly higher in patients with adenocarcinoma,squamous cell carcinoma and smallcell lung carcinoma than in patients with benign tumors( all P < 0. 05). The levels of NSE,CEA,CYFRA21-1 and Pro GRP were significantly higher in patients with stage III to IV lung cancer than in patients with stage I to II lung cancer( all P < 0. 05). The sensitivity of combined detection of NSE,CEA,CYFRA21-1 and Pro GRP was 85. 4%,86. 9% and 94. 4%,respectively for the diagnosis of adenocarcinoma,squamous cell carcinoma and small cell lung cancer and the specificity was 60. 73%,which was higher than each single index( all P < 0. 05). Conclusion NSE combined with tumor markers CEA,CYFRA21-1 and Pro GRP shows high sensitivity and specificity for the diagnosis of lung cancer with high clinical diagnostic value for early lung cancer,which can provide reliable references for clinical treatment.