EBUS-TBNA取样后C-ROSE联合肺部血清肿瘤标志物在肺癌病理分型和分型转化中的意义

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中文摘要：目的:探索联合快速现场细胞学评价(cytological rapid on-site evaluation，C-ROSE)与肺部血清肿瘤标志物对于肺癌病理分型以及分型转化的收益。方法:收集2021年10月至2023年7月我院超声支气管镜引导下的经支气管针吸活检术(endobronchialul trasound-guided transbronchial needle aspiration，EBUS-TB-NA)取样后行 C-ROSE 检查的患者125例，其中鳞癌(lung squamous cell carcinoma，LUSC)33 例，腺癌(lung adenocarcinoma，LUAD)40例，大细胞低分化癌(large cell poorly differentiated lung carcinoma，LCLC)11 例，小细胞低分化癌(small cell poorly differentiated lung carcinoma，SCLC)41 例。单独或联合分析比较患者 EBUS-TB-NA 取样后C-ROSE、肺部血清肿瘤标志物对不同病理分型肺癌的诊断阳性率。结果:C-ROSE可以提高LUSC(72。7％)、LUAD(85。0％)、LCLC(63。6％)、SCLC(53。1％)等分型肺癌的取样合格率(P＜0。05)。同时SCCAg是LUSC中的优势肺部血清肿瘤标志物(灵敏度87。9％，特异度82。6％，AUC=0。907，P＜0。05)，联合C-ROSE可提高诊断阳性率(87。9％，P＜0。05);CEA是LUAD中的优势肺部血清肿瘤标志物(灵敏度62。5％，特异度 80。0％，AUC=0。733，P＜0。05)，联合 C-ROSE 可提高诊断阳性率(97。5％，P＜0。05);ProGRP+NSE是SCLC中的优势肺部血清肿瘤标志物(灵敏度85。4％，特异度95。2％，AUC=0。943，cut-off=134。94，P＜0。05)，联合 C-ROSE 可提高诊断阳性率(90。2％，P＜0。05);NSE/ProGRP 在 LCLC 中诊断价值最高(灵敏度 90。9％，特异度 82。9％，AUC=0。894，cut-off=0。33，P＜0。05)，联合 C-ROSE 可提高诊断阳性率(100。0％，P＜0。05)。结论:EBUS-TBNA取样后C-ROSE联合肺部血清肿瘤标志物可提高对不同病理分型的肺癌的诊断阳性率并帮助预警分型转变。

外文标题：Significance of C-ROSE after EBUS-TBNA sampling combined with lung serum tumor markers in pathological classification and classification transformation of lung cancer

外文摘要：Objective:To explore the benefits of combining C-ROSE with pulmonary serum tumor markers for lung cancer pathologic classification and classification transformation.Methods:A total of 125 patients who underwent C-ROSE examination after EBUS-TBNA sampling in our hospital from October 2021 to July 2023 were collected,including 33 cases of lung squamous cell carcinoma(LUSC),40 cases of lung adenocarcinoma(LUAD),11 cases of large cell poorly differentiated lung carcinoma(LCLC)and 41 cases of small cell poorly differentiated lung carcinoma(SCLC).The diagnostic positive rates of C-ROSE and lung serum tumor markers were compared in different patho-logical types of lung cancer after EBUS-TBNA sampling alone or in combination.Results:C-ROSE can improve the sampling qualification rate of LUSC(72.7％),LUAD(85.0％),LCLC(63.6％),SCLC(53.1％)and other types of lung cancer(P＜0.05).At the same time,SCCAg was the dominant lung serum tumor marker in LUSC(sensitivity 87.9％,specificity 82.6％,AUC=0.907,P＜0.05),and C-ROSE combined with SCCAG could increase the positive rate of diagnostic efficacy(87.9％,P＜0.05).CEA was the dominant pulmonary serum tumor marker in LUAD(sensitivity 62.5％,specificity 80.0％,AUC=0.733,P＜0.05).Combined with C-ROSE could increase the positive rate of diagnostic efficacy(97.5％,P＜0.05).ProGRP+NSE was the dominant serum tumor marker in SCLC(sensitivity 85.4％,specificity 95.2％,AUC=0.943,cut-off=134.94,P＜0.05).ProGRP+NSE combined with C-ROSE can improve positive rate of the diagnostic efficacy(90.2％,P＜0.05).The diagnostic value of NSE/ProGRP was the highest in LCLC(sensitivity 90.9％,specificity 82.9％,AUC=0.894,cut-off=0.332,P＜0.05).The combination with C-ROSE could improve the positive rate of diagnostic efficacy(100.0％,P＜0.05).Conclusion:After EBUS-TBNA sampling,C-ROSE combined with lung serum tumor markers can improve the positive rate of early diagnosis of different pathological types of lung cancer and help to warn the type change.

外文关键词：

C-ROSEserum tumor markerlung cancerpathological type

作者：

程文亮、李荣、赵德华、李洁、方雨薇、李仪晴、葛晓军

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作者单位：

遵义医科大学第二附属医院检验科,贵州遵义 563000

关键词：

C-ROSE 血清肿瘤标志物肺癌病理分型

出版年：

2025

DOI：