探讨血清肿瘤标志ProGRP、NSE、CEA、CYFRA21-1、SCC单独及联合检测在肺癌鉴别诊断中的临床应用价值

Exploration of the Clinical Application Value of Serum Tumor Markers ProGRP,NSE,CEA,CYFRA21-1,SCC Alone and in Combination in the Differential Diagnosis of Lung Cancer

目的研究肺癌鉴别诊断中血清肿瘤标志物血清胃泌素释放肽前体(ProGRP)、癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、鳞状上皮细胞癌抗原(SCC)及血清细胞角蛋白19片段(CYFRA21-1)单独及联合检测的应用价值。方法选取2020年1月—2021年6月该院收治的117例肺癌患者为肺癌组,同期选取50例肺部良性疾病(BLD)患者为肺良性疾病组,所有受检者测定NSE、CEA、ProGRP、CYFRA21-1、SCC水平,分析检测结果。结果肺癌组NSE、ProGRP、CYFRA21-1、CEA及SCC水平分别为(24.22±3.77)ng/mL、(96.87±8.28)pg/mL、(4.09±1.92)ng/mL、(12.99±3.77)ng/mL、(2.09±0.45)ng/mL,均高于肺良性疾病组,差异有统计学意义(t=18.987、40.445、4.820、14.429、17.703,P<0.05);腺癌血清CEA阳性率最高,鳞癌血清SCC、CYFRA21-1阳性率均很高,SCLC血清ProGRP、NSE阳性率均很高;ProGRP检测特异性最高为98.8%,SCC检测敏感性最高为94.8%,而联合检测准确性最高为48.0%。结论肺癌鉴别诊断中血清肿瘤标志物NSE、CEA、ProGRP、CYFRA21-1、SCC单独及联合检测的应用价值均较高,联合检测诊断准确度更高,可为临床诊治提供可靠依据。

Objective To study the application value of serum tumor markers serum gastrin releasing peptide precursor(ProGRP),carcinoembryonic antigen(CEA),and neuron-specific enolase(NSE),squamous cell carcinoma antigen(SCC)and serum cytokeratin 19 fragment(CYFRA21-1)in the differential diagnosis of lung cancer.Methods 117 lung cancer patients admitted to the hospital from January 2020 to June 2021 were selected as the lung cancer group.At the same time,50 patients with benign lung disease(BLD)were selected as the benign lung disease group.All subjects were tested for NSE,CEA,ProGRP,CYFRA21-1,and SCC levels.Analyze the test results.Results The levels of NSE,ProGRP,CYFRA21-1,CEA and SCC in the lung cancer group were(24.22±3.77)ng/mL,(96.87±8.28)pg/mL,(4.09±1.92)ng/mL,(12.99±3.77)ng/mL,(2.09±0.45)ng/mL,which were higher than those in the lung benign disease group,the difference was statistically significant(t=18.987,40.445,4.820,14.429,17.703,P<0.05).Adenocarcinoma had the highest serum CEA positive rate,squamous cell carcinoma has the highest serum SCC and CYFRA21-1 positive rates,and SCLC serum ProGRP and NSE had the highest positive rates.The highest specificity of ProGRP detection was 98.8%,and the highest sensitivity of SCC detection was 94.8%.The maximum accuracy of combined detection was 48.0%.Conclusion In the differential diagnosis of lung cancer,the serum tumor markers NSE,CEA,ProGRP,CYFRA21-1,SCC are of high application value,both individually and in combination.The combined detection has higher diagnostic accuracy and can provide a reliable basis for clinical diagnosis and treatment.