癌胚抗原与神经元特异性烯醇化酶等肿瘤标志物联合检测对肺癌的诊断价值

Diagnostic value of combined detection of carcinoembryonic antigen and neuron specific enolase and other tumor markers for lung cancer

目的研究癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、鳞状上皮细胞癌抗原(SCCA)、细胞角蛋白片段19(CYFRA21-1)联合检测在肺癌诊断中的价值。方法选择2017年5月至2019年5月本院收治的肺癌患者100例为肺癌组,同期肺部良性疾病患者100例为对照组,健康体检者100例为健康组。3组对象均接受CEA、NSE、SCCA、CYFRA21-1水平检测,比较3组检测结果差异,分析上述指标单独检测与联合检测在肺癌诊断中的应用价值。结果3组患者CEA、NSE、SCCA、CYFRA21-1水平比较,差异均有统计学意义(F值分别为833.761、85.307、178.824、83.305,均P<0.001)。3组患者CEA、NSE、SCCA、CYFRA21-1指标单项检测和联合检测的阳性率比较,差异均有统计学意义(χ^(2)值分别为46.665、23.687、8.422、25.657、76.602,均P<0.05)。肺癌组中腺癌、鳞癌、小细胞肺癌患者NSE、SCCA、CYFRA21-1水平比较,差异均有统计学意义(F值分别为59.702、124.139、316.483、110.507,均P<0.001);但上述3类患者CEA水平比较差异无统计学意义(P>0.05)。CEA、NSE、SCCA、CYFRA21-1指标联合检测诊断肺癌的敏感度高于任意一项指标单独检测,差异有统计学意义(χ^(2)=41.735,P<0.05);但联合检测的特异度、准确度、阳性预测值、阴性预测值与单独检测比较差异均无统计学意义(均P>0.05)。结论CEA、NSE、SCCA、CYFRA21-1联合检测能有效提升肺癌诊断的敏感度,应用价值较高。

Objective To study the effect of combined detection of carcinoembryonic antigen(CEA),neuron specific eno⁃lase(NSE),squamous cell carcinoma antigen(SCCA)and cytokeratin fragment 19(CYFRA21-1)in the diagnosis of lung cancer.Methods 100 patients with lung cancer hospitalized in our hospital from May 2017 to May 2019 were selected as the lung cancer group,100 patients with benign lung diseases in the same period as the control group and 100 healthy subjects as the healthy group.The three groups were tested by CEA,NSE,SCCA and CYFRA21-1.The study compared the differences of the test results among these groups,and analyzed the application value of single and combined detection of the above tumor markers for lung cancer diagnosis.Results There were significant differences in the levels of CEA,NSE,SCCA and CYFRA21-1 among lung cancer group,control group and healthy group(F=833.761,85.307,178.824,83.305,all P<0.001).There was significant difference in the positive rates between the single and combined detection of four indexes among the three groups.There was significant difference in the positive rate of four indexes in the three groups(χ^(2)=46.665,23.687,8.422,25.657,76.602,P<0.05);The levels of NSE,SCCA and CYFRA21-1 in adenocarcinoma subgroup,squamous cell carcinoma subgroup and small cell lung cancer subgroup in lung cancer group were significantly different(F=59.702,124.139,316.483,110.507,P<0.001).There was no significant difference in CEA among the three groups(P>0.05);The sensitivity of the combined detection of four indexes in the diagnosis of lung cancer was higher than that of any index alone,and the difference was statistically significant(χ^(2)=41.735,P<0.05).However,the differences in specificity,accuracy,positive predictive and negative predictive value of the combined detection compared with those of the single detection were not statistically significant(all P>0.05).Conclusion The combined detection of CEA,NSE,SC⁃CA and CYFRA21-1 can effectively improve the sensitivity and positive rate of lung cancer diagnosis.