肿瘤标志物细检测对肺癌诊断的临床应用价值

Tumor markers fine detection diagnostic value for lung cancer

目的临床分析肿瘤标志物细检测应用于肺癌诊断的价值。方法选取我院2011年3月至2012年3月240例入院、体检的患者,选择其血清标本,运用荧光分析法检测血清中CA125、CA199、CA153、CYFRA21-1、NSE、CEA的浓度,并筛检出最佳组合,评价诊断肺癌的价值。结果单项检测血清中的肿瘤标志物,鳞癌组的CA123占有41.35%的灵敏度,排在首位;肺癌组的CYFRA21-1(48.57%)与CEA(49.36%)的灵敏度最高;小细胞肺癌组的CYFRA21-1(26.34%)、NSE(30.14%)与CEA(39.33%)灵敏度最高;CEA的单项检测价值最高,其约登指数0.3487,CEA+CYFRA21-1+CA125的联合检测,其筛检灵敏度最为明显,约为66.23%,针对肺腺癌患者,可达到91.5%。CEA+CYFRA21-1的联合检测,其约登指数0.4369,特异度84.77%,具有最高的诊断价值。结论针对肺癌的换则会的诊断,采用CEA的单项检测,具有最高的诊断价值,尤其是肺腺癌患者,具有极高的灵敏度。使用CEA+CY-FRA21-1+CA125的联合检测,具有较高的灵敏度,可为体检、高危人群的筛查指标。针对影像学难以确诊的肺癌患者,使用CEA+CYFR21-1联合检测,可有效提高诊断的准确性。

Objective Clinical analysis of tumor markers in diagnosis of lung cancer with fine detection applied to the value of.Methods In our hospital from2011 March to 2012 March,240 patients were admitted medical patients,selection of its serum specimens,using fluorescence analysis of detection of serum CA125,CA199,CA153,CYFRA21-1,NSE,CEA concentration,and the best combination of screen detection,evaluation and diagnosis of lung cancer.Results The results of single measurement of serum tumor markers in squamous cell carcinoma group,CA123 had a 41.35% sensitivity,ranked in the first place;lung cancer group(48.57% CYFRA21-1) and CEA(49.36%) has the highest sensitivity;small cell lung cancer group(26.34% CYFRA21-1),NSE(30.14%) and CEA(39.33%) the highest sensitivity;CEA single detection of the highest value,the Youden index 0.3487,CEA + CYFRA21-1 + CA125 joint detection,the sensitivity of screening was most obvious,of about 66.23%,in patients with adenocarcinoma of the lung,can reach 91.5%.CEA + CYFRA21-1 joint detection,the Youden index of 0.4369,a specificity of 84.77%,has the highest diagnostic value.Conclusion According to the change of lung cancer will be diagnosed,using CEA single detection,has the highest diagnostic value,especially in patients with adenocarcinoma of the lung,with high sensitivity.The use of CEA + CYFRA21-1 + CA125 joint detection,high sensitivity,for physical examination,screening index.According to the imaging to diagnosis of lung cancer patients,the use of the CEA + CYFR21-1 joint detection,can effectively improve the accuracy of diagnosis.