血清肿瘤标志物检测在肺癌诊断中的应用价值

Application Value of Serum Tumor Marker Detection in the Diagnosis of Lung Cancer

目的探讨血清肿瘤标志物检测对肺癌诊断的价值。方法选择2020年1月—2022年4月南京鼓楼医院集团仪征医院收治的肺癌患者75例为观察组,健康体检者75名为对照组,均采血检测神经元特异性烯醇化酶(neuron-specific enolase,NSE)、鳞状上皮细胞癌抗原(squamous cell carcinoma antigen,SCCA)以及细胞角蛋白19片段(cytokeratin-19-fragment,Cyfra21-1)。比较两组血清肿瘤标志物水平,评估单独检测与联合检测对肺癌的诊断效能,比较不同肺癌亚组肿瘤标志物的差异。结果观察组NSE、SCCA、Cyfra21-1分别为(19.05±4.39)、(2.97±0.75)、(8.54±3.35)ng/mL,均高于对照组,差异有统计学意义(t=22.412、23.933、16.752,P<0.05)。联合诊断准确率为93.33%,高于NSE、SCCA、Cyfra21-1单独诊断的78.00%、74.67%、81.33%,差异有统计学意义(χ^(2)=23.000、28.000、18.000,P<0.05);联合诊断灵敏度为92.00%,高于NSE、SCCA、Cyfra21-1单独诊断的60.00%、53.33%、65.33%,差异有统计学意义(χ^(2)=24.000、29.000、20.000,P<0.05)。小细胞肺癌组NSE(31.78±5.05)ng/mL高于非小细胞肺癌组,SCCA、Cyfra21-1分别为(1.94±0.32)、(5.39±1.47)ng/mL,均低于非小细胞肺癌组,差异有统计学意义(t=11.694、13.375、6.955,P<0.05)。结论肺癌患者肿瘤标志物存在异常,联合检测能有效检出肺癌,且可辅助肺癌亚组的鉴别诊断。

Objective To explore the value of serum tumor marker detection in the diagnosis of lung cancer.Methods 75 patients with lung cancer admitted to Yizheng Hospital of Nanjing Gulou Hospital Group from January 2020 to April 2022 were selected as the observation group,and 75 healthy people were selected as the control group.Blood samples were collected for neuron-specific enolase(NSE),squamous cell carcinoma antigen(SCCA),and cytokeratin-19-fragment(Cyfra21-1).The levels of serum tumor markers were compared between the two groups,the diagnostic efficacy of single detection and combined detection for lung cancer was evaluated,and the differences of tumor mark⁃ers among different lung cancer subgroups were compared.Results The values of NSE,SCCA and Cyfra21-1 in the observation group were(19.05±4.39)ng/mL,(2.97±0.75)ng/mL and(8.54±3.35)ng/mL,which were higher than those in the control group,the difference was statistically significant(t=22.412,23.933,16.752,P<0.05).The accuracy of combined diagnosis was 93.33%,which was higher than that of NSE,SCCA and Cyfra21-1 alone(78.00%,74.67%,81.33%),the difference was statistically significant(χ^(2)=23.000,28.000,18.000,P<0.05).The sensitivity of combined diagnosis was 92.00%,which was higher than that of NSE,SCCA and Cyfra21-1 alone(60.00%,53.33%,65.33%),the difference was statistically significant(χ^(2)=24.000,29.000,20.000,P<0.05).The NSE of small cell lung cancer group(31.78±5.05)ng/mL was higher than that of non-small cell lung cancer group,the level of SCCA and Cyfra21-1 were(1.94±0.32)ng/mL and(5.39±1.47)ng/mL,respectively,which were lower than those of non-small cell lung can⁃cer group,and the difference was statistically significant(t=11.694,13.375,6.955,P<0.05).Conclusion There are ab⁃normal tumor markers in patients with lung cancer.Combined detection can effectively detect lung cancer and assist in the differential diagnosis of lung cancer subgroups.