血清CEA、 D -D、ALB、NLR与非小细胞肺癌的相关性及联合诊断价值分析

The Combined Diagnosis Value of Serum CEA,D-D,ALB and NLR and Their Relationship with the Non-Small Cell Lung Cancer Patients

目的分析血清癌胚抗原(CEA)、D-二聚体(D-D)、清蛋白(ALB)、中性粒细胞/淋巴细胞比值(NLR)与非小细胞肺癌(NSCLC)的相关性,评估其诊断价值。方法收集NSCLC患者92例,根据病理类型(鳞癌组、腺癌组)、临床分期(Ⅰ+Ⅱ+Ⅲ期、Ⅳ期)、卡氏评分(KPS)(非依赖组:KPS 80~100分、半依赖组KPS:50~70分)进行分组,比较各组CEA、D-D、ALB、NLR的差异,并进行统计学分析。结果NSCLC患者中,腺癌组血清CEA、D-D水平显著高于鳞癌组(P<0.05);Ⅳ期患者血清CEA、D-D、NLR水平显著高于Ⅰ+Ⅱ+Ⅲ期患者,ALB水平显著低于Ⅰ+Ⅱ+Ⅲ期患者(P<0.05);半依赖组D-D、NLR水平显著高于非依赖组,ALB水平显著低于非依赖患者(P<0.05)。Spearman相关显示NSCLC患者病理类型与CEA、D-D水平呈正相关(P<0.05);临床分期与CEA、D-D、NLR水平呈正相关,与ALB水平呈负相关(P<0.05);KPS评分与CEA、D-D、NLR的水平呈负相关,与ALB水平呈正相关(P<0.05)。ROC曲线分析显示血清CEA+D-D联合检测较CEA、D-D单独检测对诊断NSCLC患者鳞/腺癌的灵敏度最高,依次为72.50%、58.80%、62.70%;血清CEA+D-D+NLR+ALB联合检测较CEA、D-D、ALB、NLR单独检测对评估NSCLC临床分期的灵敏度(依次为87.00%、68.10%、79.70%、82.60%、79.70%)及特异性(依次为78.30%、78.20%、52.00%、53.60%、69.60%)最高。D-D+NLR+ALB联合检测较D-D、ALB、NLR单独检测对评估身体功能状态的特异性最高,依次为84.50%、72.40%、44.10%、82.80%。结论血清CEA、D-D、ALB、NLR与NSCLC患者病情密切相关,联合检测可用于患者病理类型、临床分期及身体功能状态的鉴别诊断。

Objective To explore the relationship of serum carcinoembryonic antigen(CEA),D-dimer(D-D),albumin(ALB)and neutrophil-lymphocyte ratio(NLR)with the non-small cell lung cancer(NSCLC)patients,and evaluate their diagnosis value.Methods A total of 92 NSCLC patients were admitted in this study.All patients were divided into different groups according to the pathological type,clinical stage and the Karnofsky score(KPS),and then related data were analyzed.Results CEA and D-D levels in the adenocarcinoma group were significantly increased compared with the squamous cell carcinoma group(P<0.05).CEA,D-D and NLR levels in patients at stageⅣwere significantly higher than that at the stage I+II+III,and ALB level was lower than that at the stage I+II+III(P<0.05).D-D and NLR levels in the semi-dependent group exhibited more significant increase than that of non-dependent group,and ALB level was lower than that of the non-dependent group(P<0.05).Spearman analysis showed that the pathological type was positively correlated with CEA and D-D levels(P<0.05).The clinical stage was positively correlated with CEA,D-D and NLR levels,while negatively related with ALB level(P<0.05).KPS was negatively related with D-D and NLR levels,while positively correlated with ALB level(P<0.05).ROC analysis showed that the sensitivity of combined detection with CEA and D-D for the diagnosis of pathological type was significantly higher than that of single index,which were 72.50%,58.80%and 62.70%,respectively.The values of combined detection with CEA,D-D,ALB,NLR for the diagnosis of clinical stage were significantly higher than that of single index.The sensitivities were 87.00%,68.10%,79.70%,82.60%and 79.70%,and the specificities were 78.30%,78.20%,52.00%,53.60%,69.60%,respectively.The specificity of combined detection with D-D,ALB,NLR for the diagnosis of KPS was significantly higher than that of single index,which were 84.50%,72.40%,44.10%,and 82.80%,respectively.Conclusion Serum CEA,D-D,ALB,NLR are closely related with NSCLC patients,and combined detection could be used for the diagnosis of pathological type,clinical stage and physical function status of the disease.