神经元特异性烯醇化酶、细胞角蛋白19片段抗原21-1联合癌胚抗原在老年肺癌诊断中的应用

Application effect of neuron specifific enolase,cyto-kerantin 19 fragment antigen 21-1 and carcinoembryonic antigen in the diagnosis of senile lung cancer

目的探讨血清神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段抗原21-1(CYFRA21-1)及血清癌胚抗原在老年肺癌诊断中的应用效果。方法选取2017年5月至2021年4月福建省级机关医院七区呼吸科收治并经病理证实为肺癌的207例老年患者为肺癌组,男174例,女33例,年龄(57.26±5.57)岁,年龄范围为46~72岁,另选取同期至福建省级机关医院体检的207名健康老年人为健康组,男166名,女41名,年龄(59.85±6.06)岁,年龄范围为49~73岁。比较两组血清NSE、CYFRA21-1、癌胚抗原肿瘤标志物水平,比较不同肺癌分型患者血清NSE、CYFRA21-1、癌胚抗原肿瘤标志物水平,比较联合检测与单独检测肺癌组血清NSE、CYFRA21-1、癌胚抗原的效果评价。结果肺癌组血清NSE[(20.14±5.37)μg/L]、CYFRA21-1[(9.71±7.44)μg/L]、癌胚抗原肿瘤标志物水平[(12.28±8.51)μg/L]均高于健康组[(5.62±2.59)μg/L、(2.18±0.83)μg/L、(2.36±1.01)μg/L],差异有统计学意义(P<0.05)。小细胞肺癌患者的NSE[(33.14±7.25)μg/L]高于肺鳞癌[(26.78±4.39)μg/L]、肺腺癌患者[(19.68±7.51)μg/L],肺鳞癌患者的CYFRA21-1水平[(15.22±8.74)μg/L]高于小细胞肺癌[(5.01±4.13)μg/L]、肺腺癌患者[(9.15±6.91)μg/L],肺腺癌患者的癌胚抗原水平[(23.82±10.94)μg/L]高于小细胞肺癌[(8.21±7.67)μg/L]、肺鳞癌患者[(16.27±9.33)μg/L],差异有统计学意义(P<0.05)。肺癌组患者血清NSE、CYFRA21-1、癌胚抗原3种联合检测的灵敏度、特异度及准确性显著高于单独检测,差异有统计学意义(P<0.05)。结论血清NSE、CYFRA21-1、癌胚抗原联合检测在老年肺癌诊断及分型鉴别诊断中应用效果显著,值得临床借鉴。

Objective Discussion of the application effect of serum neuron-specifific enolase(NSE),cyto-kerantin 19 fragment antigen 21-1(CYFRA21-1)and carcinoembryonic antigen(CEA)in the diagnosis of senile lung cancer.Methods The 207 elderly patients admitted in the 7th district from May 2017 to April 2021 were 207 lung cancer,174 males,33 females,age(57.26±5.57)years old,and the age range of 46 to 72 years old.In addition,the 207 healthy elderly people from the same period to Fujian provincial government hospital for physical examination were selected as the health group,166 males,41 females,age(59.85±6.06)years old,and the age range of 49 to 73 years old.Comparing serum NSE,CYFRA21-1,CEA tumor markers in the two groups,comparing serum NSE,CYFRA21-1,CEA tumor markers in different lung cancer patients,and comparing the effect evaluation of serum NSE,CYFRA21-1,CEA in separate lung cancer groups.Results Serum NSE[(20.14±5.37)μg/L],CYFRA21-1[(9.71±7.44)μg/L],and CEA tumor markers levels[(12.28±8.51)μg/L]were all higher than the health groups[(5.62±2.59)μg/L,(2.18±0.83)μg/L,(2.36±1.01)μg/L],the differences were statistically significant(P<0.05).The NSE[(33.14±7.25)μg/L]in small cell lung cancer is higher than lung squamous carcinoma[(26.78±4.39)μg/L)and patients with lung adenocarcinoma[(19.68±7.51)μg/L],the CYFRA21-1[(15.22±8.74)μg/L]in patients with lung squamous carcinoma were higher than in small cell lung cancer[(5.01±4.13)μg/L)and patients with lung adenocarcinoma[(9.15±6.91)μg/L],The CEA[(23.82±10.94)μg/L]in patients with lung adenocarcinoma were higher than small cell lung cancer[(8.21±7.67)μg/L)and patients with pulmonary squamous carcinoma[(16.27±9.33)μg/L],the differences were statistically significant(P<0.05).The sensitivity,specificity and accuracy of serum NSE,CYFRA21-1,CEA were significantly higher than in lung cancer group,the differences were statistically significant(P<0.05).Conclusion Combined test of serum NSE,CYFRA21-1,CEA was effective in the diagnosis of senile lung cancer and typing,which is worth clinical reference.