G抗原7、细胞角蛋白十九片段和癌胚抗原在非小细胞肺癌转移中的预测价值

Predictive value of G antigen 7, cytokeratin 19 fragment and carcinoembryonic antigen in non-small cell lung cancer metastasis

目的 探讨G抗原7(G antigen 7,GAGE7)、细胞角蛋白十九片段(cytokeratin 19 fragment, CYFRA21-1)和癌胚抗原(carcinoembryonic antigen, CEA)在非小细胞肺癌(non-small cell lung cancer, NSCLC)转移中的预测价值,以确定NSCLC转移的潜在风险因素。方法 选取2018年1月—2021年10月的NSCLC住院患者226例,分为转移组103例和无转移组123例。比较2组患者的肿瘤标记物、肺癌自身七项抗体和血常规指标,结合受试者临床资料,使用logistic回归分析来确定风险因素,用受试者工作曲线(ROC)来评估NSCLC转移的诊断价值。结果 logistic回归表明,GAGE7、CEA、CYFRA21-1是NSCLC患者转移的独立危险因素(P<0.05)。GAGE7、CYFRA21-1、CEA以及三者联合的AUC分别为0.610、0.770、0.781以及0.845,三者联合的AUC高于单独检测。GAGE7的敏感度和特异度分别为75.00%和56.07%;CYFRA21-1的敏感度和特异度分别为87.18%和63.10%;CEA的敏感度和特异度分别为88.89%和68.02%。三者联合敏感度和特异度分别为84.00%和73.51%。结论 GAGE7、CYFRA21-1、CEA联合检测可提高预测NSCLC转移的敏感度和特异度。

Objective This study aims to investigate the predictive value of G antigen 7(GAGE7), cytokeratin 19 fragment(CYFRA21-1) and carcinoembryonic antigen(CEA) in the metastasis of non-small cell lung cancer(NSCLC), so as to identify the potential risk factors for NSCLC metastasis. Methods Two hundred and twenty-six inpatients with NSCLC from January 2018 to October 2021 were selected and divided into metastasis group(n=103) and non metastasis group(n=123). Tumor markers, seven antibodies against lung cancer and routine blood indicators were compared between the two groups;combined with subjects’ clinical information, logistic regression analysis was used to identify risk factors, and the subject operating curve(ROC) was used to assess the diagnostic value of NSCLC metastasis. Results Logistic regression showed that GAGE7, CEA, and CYFRA21-1 were independent risk factors for metastasis in NSCLC patients(P<0.05). The AUCs of individual GAGE7, CYFRA21-1, CEA and the combination of the three were 0.610, 0.770, 0.781 and 0.845, respectively, and the AUCs of the combination of the three were higher than those of every individual. The sensitivity and specificity of GAGE7 were 75.00% and 56.07%, respectively;the sensitivity and specificity of CYFRA21-1 were 87.18% and 63.10%, respectively;and the sensitivity and specificity of CEA were 88.89% and 68.02%, respectively. The combined sensitivity and specificity of the three were 84.00% and 73.51%, respectively. Conclusion Combined detection of GAGE7, CYFRA21-1 and CEA improves the sensitivity and specificity of predicting NSCLC metastasis.