血清CEA、SCCA、CYFRA21-1对非小细胞肺癌和5年预后的联合诊断价值

Combined Diagnostic Value of Serum CEA,SCCA and CYFRA21-1 in Non-small Cell Lung Cancer and 5-year Prognosis

目的:探究肺癌相关肿瘤标志物癌胚抗原(carcinoembryonic antigen,CEA)、鳞状细胞癌相关抗原(squamous cell carcinoma associated antigen,SCCA)和细胞角蛋白片段21-1(cytokeratin fragment 21-1,CYFRA21-1)在诊断非小细胞肺癌(non small cell lung cancer,NSCLC)风险预测中的价值。方法:选择2013年3月-2015年3月于我院治疗的86例NSCLC患者作为研究对象,另选53例健康体检者作为对照组。比较两组研究对象血清CEA、SCCA、CYFRA21-1水平;分析其与患者临床分期、病理分型特征的关系;Pearson法检验三者之间的相关性;ROC曲线计算三者及三者联合诊断NSCLC的曲线下面积(AUC)值;根据临界值将患者分为高、中、低风险组,Kaplan-Meier法绘制生存曲线分析三组患者5年生存率。结果:NSCLC组患者血清CEA、SCCA、CYFRA21-1水平显著高于对照组;Ⅰ~Ⅱ期和Ⅲ~Ⅳ期患者血清CEA、SCCA、CYFRA21-1水平差异具有统计学意义,淋巴结转移患者血清CEA、CYFRA21-1水平显著上升;CEA、SCCA、CYFRA21-1间分别呈显著正相关;CEA、SCCA、CYFRA21-1诊断NSCLC的AUC值分别为0.718、0.811、0.792,临界值分别为25.47、0.97和9.64 ng/mL,三者联合诊断的AUC值为0.854;低风险组患者5年生存率为72.73%,显著高于高风险组(13.21%)和中风险组(27.27%)。结论:CEA、SCCA、CYFRA21-1在NSCLC患者血清中高表达,CEA、SCCA、CYFRA21-1与患者的病理分期密切相关,CEA、CYFRA21-1与患者的淋巴细胞转移密切相关,三者联合检测显著提高对NSCLC的诊断效能,CEA、SCCA、CYFRA21-1对患者的预后也具有较高的预测价值。

Objective To explore the value of lung cancer-related tumor markers CEA,SCCA,and CYFRA21-1 in the diagnosis of non-small cell lung cancer(NSCLC)risk prediction.Method A total of 86 NSCLC patients treated in our hospital from March 2013 to March 2015 were selected as the research subjects,and 53 healthy subjects were selected as the control group.The levels of serum CEA,SCCA and CYFRA21-1 were compared between the two groups.The relationship between clinical stage and pathological characteristics of patients was analyzed.The correlation between the three was tested by Pearson method.ROC curves were used to calculate the area under curve(AUC)values of the three factors and their combined diagnosis of NSCLC.Patients were divided into high,medium and low risk groups according to the critical value,and Kaplan-Meier survival curve was drawn to analyze the 5-year survival rate of the three groups.Results The serum levels of CEA,SCCA and CYFRA21-1 in the NSCLC group were significantly higher than those in the control group.The differences in the levels of serum CEA,SCCA,and CYFRA21-1 in patients with stage I-II and stageIII-IV were statistically significant.The serum CEA,CYFRA21 in patients with lymph node metastasis-1 level was significantly increased,and CEA,SCCA and CYFRA21-1 were significantly positively correlated.CEA,SCCA,and CYFRA21-1 for diagnosis of NSCLC had AUC values of 0.718,0.811,and 0.792,with cut-off values of 25.47 ng/mL,respectively,0.97 ng/mL and 9.64 ng/mL respectively.The AUC value of the combined diagnosis of the three was 0.854.The 5-year survival rate in the low-risk group was 72.73%,which was significantly higher than that in the high-risk group(13.21%)and medium-risk group(27.27%).Conclusion CEA,SCCA,and CYFRA21-1 are highly expressed in the serum of NSCLC patients.CEA,SCCA and CYFRA21-1 are closely related to the patient's pathological stage.CEA and CYFRA21-1 are closely related to the patient's lymphocyte metastasis.The combined detection of CEA,SCCA and CYFRA21-1 significantly improves the diagnostic efficiency of NSCLC.CEA,SCCA and CYFRA21-1 also have high predictive value for the prognosis of patients.