血清CYFRA21-1、CA125、CEA、NSE及SCCA联合检测在肺癌诊断中的价值

Value of Combined Detection of CYFRA21-1,CA125,CEA,NSE and SCCA Serum in the Diagnosis of Lung Cancer

目的探讨血清细胞角蛋白19片段(CYFRA21-1)、糖类抗原(CA125)、癌胚抗原(CEA)、神经特异性烯醇化酶(NSE)及鳞状上皮细胞癌抗原(SCCA)等肿瘤标志物联合检测在肺癌诊断中的意义及效能。方法选取2023年2月至2024年2月厦门大学附属中山医院收治的109例肺癌患者设为肺癌组,并根据不同疾病种类,分为腺癌组61例、鳞癌组30例、小细胞癌组18例。75例肺部良性疾病患者为肺部良性疾病组,同期49名健康体检者为对照组,对比三组及不同亚组间的血清肿瘤标志物水平,对比三组及不同亚组间各项指标检测阳性率。结果肺癌组CYFRA21-1、CA125、CEA、NSE、SCCA水平及阳性率均较肺部良性疾病组和对照组高(均P<0.05)。肺癌不同亚组间比较CA125无差异(P>0.05)。腺癌组CEA阳性率、CEA水平较鳞癌组、小细胞癌组高,鳞癌组CYFRA21-1、SCCA阳性率,及CYFRA21-1、SCCA水平较腺癌组、小细胞癌组高,小细胞癌组NSE阳性率、NSE水平较腺癌组、鳞癌组高(均P<0.05)。结论肺癌诊断中联合多种血清肿瘤标志物检测的价值较高,5种血清指标在肺癌不同病理分型中水平表达存在一定差异性,联合检测具有更高诊断效能,可避免发生漏诊、误诊。

Objective To investigate the significance and efficacy of combined detection of cytokeratin-19 fragment(CYFRA21-1),carbohydrate antigen(CA125),carcinoembryonic antigen(CEA),neuron-specific enolase(NSE)and squamous cell carcinoma antigen(SCCA)in the diagnosis of lung cancer.Methods A total of 109 lung cancer patients admitted to Zhongshan Hospital of Xiamen University from February 2023 to February 2024 were selected as the lung cancer group,and were divided into 61 adenocarcinoma,30 squamous carcinoma,and 18 small-cell carcinoma according to the different types of the disease,and 75 patients with benign lung diseases as the group of benign lung diseases,and 49 healthy medical checkups in the same period of time as the control group,and the levels of serum tumour markers were compared among the three groups and the different subgroups.The serum levels of tumour markers were compared among the three groups and different subgroups,and the positive rates of each index were compared among the three groups and different subgroups.Results The levels and positivity rates of CYFRA21-1,CA125,CEA,NSE,and SCCA were higher in the lung cancer group than in the benign lung disease group and the control group(all P<0.05).There was no difference in CA125 when comparing between different subgroups of lung cancer(P>0.05).The CEA positivity rate and CEA level were higher in the adenocarcinoma group than in the squamous carcinoma group and small cell carcinoma group,the CYFRA21-1 and SCCA positivity rate,and CYFRA21-1 and SCCA levels were higher in the squamous carcinoma group than in the adenocarcinoma group and the small cell carcinoma group,and the NSE positivity rate and NSE level in the small cell carcinoma group were higher than those in the adenocarcinoma group and the squamous carcinoma group(all P<0.05).Conclusions The combined detection of multiple serum tumor markers is of high value in the diagnosis of lung cancer,and there are differences in the level expression of the five serum markers in different pathological types of lung cancer.The combined detection has higher diagnostic efficiency and can avoid missed diagnosis and misdiagnosis.