血清CEA、NSE、SCC-Ag和CA125联合检验在非小细胞肺癌中的诊断价值

The Diagnostic Value of Serum CEA,NSE,SCC-Ag,and CA125 Combined Test in Non-small Cell Lung Cancer

目的探究血清癌胚抗原(CEA)、神经特异性烯醇化酶(NSE)、鳞癌相关抗原(SCC-Ag)、糖类抗原125(CA125)联合检验在非小细胞肺癌(NSCLC)中的诊断价值。方法选取2021年1月至2024年1月在本院就诊的110例NSCLC患者作为NSCLC组,另选取同期在本院体检的健康志愿者50例作为对照组。比较2组血清CEA、NSE、SCC-Ag以及CA125水平的差异;依据病理T分期将NSCLC组患者分为T1期、T2期、T3期3个不同亚组,依据病理N分期将NSCLC患者分为N0期、N1期、N2期3个不同亚组,比较不同病理T分期、N分期NSCLC患者血清CEA、NSE、SCC-Ag以及CA125水平的差异;并绘制ROC曲线分析上述指标单一及联合在NSCLC诊断中的效能。结果在CEA、NSE、SCC-Ag、CA125水平比较上,NSCLC组均高于对照组(P<0.05)。血清CEA、NSE、SCC-Ag、CA125水平均随NSCLC患者病理T分期的递增而升高(P<0.05),且各分期结果比较差异有统计学意义(P<0.05)。血清CEA、NSE、SCC-Ag、CA125水平均随NSCLC患者病理N分期的递增而升高(P<0.05),且各分期结果比较差异有统计学意义(P<0.05)。CEA、NSE、SCC-Ag、CA125诊断NSCLC的AUC分别为0.869(95%CI为0.827~0.917)、0.873(95%CI为0.812~0.921)、0.854(95%CI为0.789~0.905)、0.826(95%CI为0.758~0.881),4者联合诊断NSCLC的AUC为0.982(95%CI为0.947~0.996),均较CEA、NSE、SCC-Ag、CA125各单一指标效能更高(Z=4.152、4.268、4.663、4.783,P<0.001)。结论血清CEA、NSE、SCC-Ag、CA125与NSCLC病理类型、淋巴结转移数目、EGFR基因型等存在关系,且通过联合检测CEA、NSE、SCC-Ag、CA125水平可有效提高临床诊断NSCLC的效能。

Objective To explore the diagnostic value of a combined test of serum carcinoembryonic antigen(CEA),neural specific enolase(NSE),squamous cell carcinoma associated antigen(SCC-Ag),and carbohydrate antigen 125(CA125)in non-small cell lung cancer(NSCLC).Methods 110 NSCLC patients who visited our hospital from January,2021 to January,2024 were selected as the NSCLC group,while 50 healthy volunteers who underwent physical examinations at our hospital during the same period were selected as the control group.We identified and evaluated differences in serum CEA,NSE,SCC-Ag,and CA125 levels between these two groups;According to the pathological T stage,NSCLC patients were divided into three different subgroups:T1,T2,and T3.Based on the pathological N stage,NSCLC patients were divided into three different subgroups:N0,N1,and N2.The differences in serum CEA,NSE,SCC-Ag,and CA125 levels among NSCLC patients with different pathological T stages and N stages were identified and evaluated;ROC curves were drawn to analyze the effectiveness of single and combined indicators in the diagnosis of NSCLC.Results In comparison of CEA,NSE,SCC-Ag,and CA125 levels,the NSCLC group was higher than the control group(P<0.05).Levels of serum CEA,NSE,SCC-Ag,and CA125 all increased with the increase of pathological T stage in NSCLC patients(P<0.05),and the differences in results of each stage were statistically significant(P<0.05).Levels of serum CEA,NSE,SCC-Ag,and CA125 all increased with the increase of pathological N-stage in NSCLC patients(P<0.05),and the differences in results of each stage were statistically significant(P<0.05).AUCs of CEA,NSE,SCC-Ag,and CA125 in diagnosing NSCLC were 0.869(95%CI,0.827-0.917),0.873(95%CI,0.812-0.921),0.854(95%CI,0.789-0.905),and 0.826(95%CI,0.758-0.881),respectively.AUC of four markers combined in diagnosing NSCLC was 0.982(95%CI,0.947-0.996),all of which were more effective than the single indicators of CEA,NSE,SCC-Ag,and CA125(Z=4.152,4.268,4.663,4.783,P<0.001).Conclusion There is an association between serum CEA,NSE,SCC-Ag,CA125 and the pathological type,number of lymph node metastases,and EGFR genotype of NSCLC.Combined detection of CEA,NSE,SCC-Ag,and CA125 levels can effectively improve the clinical diagnostic efficiency of NSCLC.