血清癌胚抗原、细胞角蛋白片段19、鳞状细胞癌抗原、血清铁蛋白、C反应蛋白对非小细胞肺癌的诊断效能

Diagnostic efficacy of CEA,cytokeratin fragment 19,SCC,SF,and CRP in non-small-cell lung cancer

目的观察血清癌胚抗原(CEA)、细胞角蛋白片段19(CYFRA21-1)、鳞状细胞癌抗原(SCC)、血清铁蛋白(SF)、C反应蛋白(CRP)对非小细胞肺癌(NSCLC)的诊断效能,为NSCLC的早期诊断提供参考。方法经病理证实的NSCLC患者316例,记为NSCLC组;同期住院的其他肺病患者316例作为对照组。患者入院后采集肘部静脉血,采用免疫比浊法检测血清CRP,采用化学发光法检测血清CEA、CYFRA21-1、SCC、SF,比较两组患者血清CEA、CYFRA21-1、SCC、SF、CRP水平,采用多因素logistic回归分析法分析NSCLC发病的影响因素。绘制受试者工作特征曲线,评价血清CEA、CYFRA21-1、SCC、SF、CRP单项检测或多项指标联合检测对NSCLC的诊断效能。结果NSCLC组患者血清CEA、CYFRA21-1、SCC、SF、CRP水平均高于对照组(P均<0.05),血清CRP、CEA、CYFRA21-1、SCC、SF水平是NSCLC发病的影响因素(P均<0.05)。血清CRP、CEA、CYFRA21-1、SCC、SF单项检测诊断NSCLC的AUC分别为73.4%、72.1%、70.1%、64.9%、70.0%。CRP+CEA、CRP+SCC、CRP+SF、CEA+CYFRA21-1、CYFRA21-1+SCC、CYFRA21-1+SF两项指标联合检测诊断NSCLC的AUC分别为79.1%、73.7%、77.3%、76.4%、71.2%、76.6%。CRP+CEA+CYFRA21-1、CRP+CEA+SCC、CRP+CEA+SF、CRP+CYFRA21-1+SCC、CRP+CYFRA21-1+SF、CRP+SCC+SF、CEA+CYFRA21-1+SCC、CEA+CYFRA21-1+SF、CYFRA21-1+SCC+SF三项指标联合检测诊断NSCLC的AUC分别为80.7%、80.4%、81.3%、77.2%、79.9%、79.8%、77.3%、81.3%、78.4%。CEA+CYFRA21-1+SCC+CRP、CEA+CYFRA21-1+SCC+SF四项指标联合检测诊断NSCLC的AUC分别为81.2%、82.3%。五项指标联合检测诊断NSCLC的AUC为84%。结论NSCLC患者血清CEA、CYFRA21-1、SCC、SF、CRP水平升高,是NSCLC发病的影响因素。检测血清CEA、CYFRA21-1、SCC、SF、CRP有助于NSCLC的诊断,且多项指标联合检测的诊断效能优于单项检测。

Objective To observe the diagnostic efficiency of serum carcinoembryonic antigen(CEA),cytokeratin fragment 19(CYFRA21-1),squamous cell carcinoma antigen(SCC),serum ferritin(SF),and C-reactive protein(CRP)in non-small-cell lung cancer(NSCLC),and to provide a reference for the early diagnosis of NSCLC.Methods Totally 316 patients with NSCLC confirmed by pathology were recruited as the NSCLC group.Meanwhile,316 patients with other pulmonary diseases admitted at the same time were recruited as the control group.Blood was collected from the antecubital vein of the patients after admission.Serum CRP was detected by immunoturbidimetry,and serum CEA,CYFRA21-1,SCC,and SF were detected by chemiluminescence.The levels of serum CEA,CYFRA21-1,SCC,SF,and CRP in the two groups were compared,and the influencing factors of NSCLC were analyzed by multivariate Logistic regression analysis.The receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic effi cacy of single or combined detection of serum CEA,CYFRA21-1,SCC,SF,and CRP for NSCLC.Results The levels of serum CEA,CYFRA21-1,SCC,SF,and CRP in the NSCLC group were higher than those in the control group(all P<0.05).Serum CRP,CEA,CYFRA21-1,SCC,and SF were the influencing factors of NSCLC(all P<0.05).The AUCs of serum CRP,CEA,CYFRA21-1,SCC,and SF in diagnosing NSCLC were 73.4%,72.1%,70.1%,64.9%,and 70.0%,respectively.The AUCs of CRP+CEA,CRP+SCC,CRP+SF,CEA+CYFRA21-1,CYFRA21-1+SCC,and CYFRA21-1+SF in diagnosing NSCLC were 79.1%,73.7%,77.3%,76.4%,71.2%,and 76.6%,respectively.The AUCs of CRP+CEA+CYFRA21-1,CRP+CEA+SCC,CRP+CEA+SF,CRP+CYFRA21-1+SCC,CRP+CYFRA21-1+SF,CRP+SCC+SF,CEA+CYFRA21-1+SCC,CEA+CYFRA21-1+SF,and CYFRA21-1+SCC+SF in diagnosing NSCLC were 80.7%,80.4%,81.3%,77.2%,79.9%,79.8%,77.3%,81.3%,and 78.4%,respectively.The AUCs of CEA+CYFRA21-1+SCC+CRP and CEA+CYFRA21-1+SCC+SF in diagnosing NSCLC were 81.2%and 82.3%,respectively.The AUC of the five-item combination detection was 84%.Conclusions The levels of CEA,CYFRA21-1,SCC,SF,and CRP in serum of NSCLC patients are elevated and constitute influencing factors in the pathogenesis of NSCLC.Detecting the levels of CEA,CYFRA21-1,SCC,SF,and CRP can facilitate the diagnosis of the disease,and the diagnostic efficacy of multi-marker combination detection is superior to that of single-marker detection.