叶酸受体阳性循环肿瘤细胞结合肿瘤标志物对肺癌诊断的研究

Study of folate receptor-positive circulating tumor cells combined with tumor markers for the diagnosis of lung cancer

目的探讨叶酸受体阳性循环肿瘤细胞(FR^(+)-CTC)单独及联合肿瘤标志物癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)辅助诊断肺癌的有效性。方法收集2019年12月至2022年10月于四川省人民医院就诊的肺部结节患者的临床资料,根据结节的病理性质分为良性组188例和恶性组412例。分析FR^(+)-CTC与肺癌之间的关系,探讨联合检测肿瘤标志物对肺癌的诊断价值。结果恶性组FR^(+)-CTC水平高于良性组;恶性组中不同病理类型、TNM分期、临床分期患者的FR^(+)-CTC水平比较,差异有统计学意义(P<0.05)。FR^(+)-CTC在单独诊断肺癌的灵敏度、特异性均显著优于两种肿瘤标志物,联合诊断后FR^(+)-CTC在诊断肺癌的特异性方面有提升(P<0.05)。结论FR^(+)-CTC对于肺癌的诊断能力突出,可对患者病情进展、预后评估提供参考;联合肿瘤标志物能够提升诊断肺癌的特异性。

Objective To investigate the effectiveness of folate receptor-positive circulating tumor cells(FR^(+)-CTC)alone and in combination with tumor markers such as carcinoembryonic antigen(CEA)and CYFRA21-1 in the diagnosis of lung cancer.Methods Clinical data of patients with pulmonary nodules treated in the Sichuan Provincial People's Hospital from December 2019 to October 2022 were collected.The patients were divided into a benign group(n=188)and a malignant group(412)according to nodule pathological properties.The relationship between FR^(+)-CTC and lung cancer was analyzed.The diagnostic value of FR^(+)-CTC combined with of the tumor markers for lung cancer was explored.Results The level of FR^(+)-CTC in the malignant group was higher than that in the benign group.The differences in FR^(+)-CTC levels among different pathological types,TNM stages,and clinical stages in the malignant group were statistically significant(P<0.05).The sensitivity and specificity of FR^(+)-CTC in the diagnosis of lung cancer alone were significantly better than those of the two tumor markers,and the specificity of FR^(+)-CTC in the diagnosis of lung cancer was improved after combination with the two tumor markers(P<0.05).Conclusions FR^(+)-CTC has outstanding diagnostic ability for lung cancer.It can provide references for patient progression and prognosis assessment.The combination of tumor markers can improve the specificity of lung cancer diagnosis.