联合检测肿瘤标志物和自身抗体对非小细胞肺癌早期诊断的临床价值

Clinical Value of Combined Detection of Tumor Markers and Autoantibodies in Early Diagnosis of Non-small Cell Lung Cancer

目的探讨联合检测肿瘤标志物和自身抗体对非小细胞肺癌早期诊断的临床价值。方法纳入经组织病理确定的非小细胞癌患者82例,明确分型(鳞状细胞癌、腺癌和大细胞癌)及TNM分期,设为非小细胞肺癌组。选取同期肺部良性组和健康体检组患者82例设为对照组。通过酶联免疫吸附实验测定2组样本血清中的自身抗体(p53、CAGE和PGP9.5);采用电化学发光法检测样本中的肿瘤标志物(CYFRA21-1、CEA和SCC)水平。收集实验数据并进行统计学分析。结果单独检测自身抗体阳性率为82.9%;敏感性为82.9%;特异性为72.8%;阳性预测值75.3%;阴性预测值80.9%。单独检测肿瘤标志物阳性率为54.7%;敏感性为54.7%;特异性为81.4%;阳性预测值74.3%;阴性预测值64.0%。联合检测自身抗体和肿瘤标志物敏感性为92.9%;特异性为74.3%;阳性预测值78.3%;阴性预测值91.2%。结论单独检测肿瘤标志物或自身抗体对肺癌的诊断敏感度和特异度均达不到二者联合检测的程度,并且同时检测的阴性预测值高达91.2%,所以二者的同时检测能够更好地提高非小细胞肺癌的检出率。

Objective To explore the clinical value of combined detection of tumor markers and autoantibodies in the early diagnosis of non-small cell lung cancer.Methods 82 patients with non-small cell carcinoma confirmed by histopathology were selected.The classification(squamous cell carcinoma,adenocarcinoma and large cell carcinoma)and TNM staging were set as non-small cell carcinoma.Cell lung cancer group.82 patients in the benign lung group and healthy physical examination group during the same period were selected as the control group.The autoantibodies(p53,CAGE and PGP9.5)in the serum of the 2 groups of samples were determined by enzyme-linked immunosorbent assay;the tumor markers(CYFRA21-1,CEA and SCC)in the samples were detected by electrochemiluminescence method.Collect experimental data and perform statistical analysis.ResultsThe positive rate,sensitivity,specificity,positive predictive value and negative predictive value were 82.9%,72.8%,75.3%and 80.9%respectively.The positive rate,sensitivity,specificity,positive predictive value and negative predictive value were 54.7%,54.7%,81.4%,74.3%and 64.0%respectively.The sensitivity,specificity,positive predictive value and negative predictive value were 92.9%,74.3%,78.3%and 91.2%respectively.Conclusion The diagnostic sensitivity and specificity of the detection of tumor markers and autoantibodies in the early diagnosis of lung cancer cannot reach the degree of combined detection of the 2 cases,and the positive predictive value and negative predictive value of individual detection are not ideal.In the early diagnosis of lung cancer,the simultaneous detection of the two can improve the detection rate of patients.Because the negative predictive value of simultaneous detection was as high as 91.2%,the possibility of lung cancer could be ruled out if both results were negative.However,it is worth noting that the sensitivity of combined detection is improved,but the specificity is not satisfactory.Combined detection can improve the sensitivity,not the more the better the combination,the appropriate combination can not only improve the diagnostic efficiency,but also avoid the waste of excessive medical resources and reduce the medical costs of the patients.