非小细胞肺癌患者鳞状上皮细胞癌抗原、人附睾蛋白水平检测在预后评估中的应用价值分析

Analysis of the application value of detection of SCC-Ag and HE levels in the prognosis evaluation of patients with non-small cell lung cancer

目的分析鳞状上皮细胞癌抗原(SCC)、人附睾蛋白(HE4)在非小细胞肺癌(NSCLC)患者血清中的表达水平及在预后评估中的作用。方法2015年4月至2018年4月我院收治的128例NSCLC患者、75例肺部良性病变患者、56例健康体检者,分别设为NSCLC组、良性组、健康组。比较分析不同人群和不同临床特征NSCLC患者的SCC、HE4表达水平,以及SCC、HE4与NSCLC生存预后价值。结果三组SCC、HE4的表达水平比较NSCLC组>良性组>健康组(P<0.05)。III~IV期、低分化、有淋巴转移患者的SCC、HE4水平明显高于I~II期、中高分化、无淋巴转移患者(P<0.05);比较NSCLC患者鳞癌与腺癌分型中的SCC、HE4水平,差异均无统计学意义(P>0.05)。随访3年,NSCLC组生存者58例,死亡者70例,生存率45.31%,生存组SCC、HE4表达水平明显低于死亡组(P<0.05)。二者联合检测AUC、灵敏度、特异度分别为0.974(95%CI0.919~1.000),0.974、0.880,各指标显著高于其他单一检测(P<0.05)。结论SCC、HE4在NSCLC中存在高表达,二者联合诊断为预测NSCLC患者生存预后提供了重要临床意义。

Objective To analyze the expression levels of squamous cell carcinoma antigen(SCC)and human epydidymal protein 4(HE4)in the serum of patients with non-small cell lung cancer(NSCLC)and their roles in prognosis evaluation.Methods 128patients with NSCLC,75 patients with benign lung lesions,and 56 healthy subjects from April 2015 to April 2018 were retrospectively analyzed.They were set as a NSCLC group,a benign group,and a healthy group,respectively.The expression levels of SCC and HE4 in NSCLC patients with different populations and clinical characteristics,and the NSCLC survival prognostic value of SCC and HE4 were compared and analyzed.Results Comparison of the expression levels of SCC and HE4 in the three groups showed that the NSCLC group>the benign group>the healthy group(P<0.05).The levels of SCC and HE4 in patients with stage III-IV,poor differentiation,and lymphatic metastasis were significantly higher than those of patients with stage I-II,moderate differentiation,and no lymphatic metastasis(P<0.05).Comparison of levels of SCC and HE4 of squamous cell carcinoma and adenocarcinoma in NSCLC patients,the differenceswere no statistically significant(P>0.05).After 3 years of follow-up,there were 58 survivors and 70 deaths in the NSCLC group.The survival rate was 45.31%.The expression levels of SCCand HE4 in the survival group were significantly lower than those in the death group(P<0.05).The area underthe ROC curve(AUC),sensitivityand specificity of the combined detection of the two indexes were 0.974(95%CI:0.919~1.000),0.974 and 0.880,respectively,whichwere significantly higher than those of the single detection(P<0.05).Conclusion SCC and HE4 are highly expressed in NSCLC.The combined diagnosis of the two indexes hasan important clinical significance for predicting the survival and prognosis of NSCLC patients.