摘要
目的 探讨肿瘤标志物检测对于诊断肺癌的应用效果.方法 选择2020年7月—2022年7月在泰安市肿瘤防治院就诊的 310 例肺癌患者作为肺癌组,将同期收治的 310 例肺部良性疾病患者纳入肺病组,将同期 310 例健康体检者纳入健康对照组.三组受检者均进行肿瘤标志物检验,应用全自动电化学发光免疫分析仪测定癌胚抗原(CEA)、糖类抗原 125(CA125)、细胞角蛋白 19 片段(CYFRA21-1)、鳞状上皮细胞癌抗原(SCC)、神经特异性烯醇化酶(NSE).比较各组的肿瘤标志物检测结果和阳性率,以及不同肺癌病理类型和不同肿瘤分期患者的上述指标检测结果,考察各指标联合检验对肺癌的诊断效能.结果 肺癌组的单项指标检测值以及联合检验阳性检出率均明显高于肺病组[CEA(μg/L):10.80±2.34 比 4.26±0.75;CA125(kU/L):84.79±8.42 比 29.26±4.07;CYFRA21-1(μg/L):42.14±5.64 比 2.57±0.53;SCC(μg/L):4.77±1.02 比 1.30±0.34;NSE(μg/L):25.16±4.38 比 12.23±2.01;均P<0.05],健康对照组的各项指标检测值均低于其他两组,差异均有统计学意义.肺癌组中,CEA水平最低的为鳞癌患者,最高的为腺癌患者,CA125、CYFRA21-1 水平由高到低为腺癌、鳞癌、小细胞肺癌患者,NSE水平由低到高为腺癌、鳞癌、小细胞肺癌患者,SCC水平由高到低为鳞癌、小细胞肺癌、腺癌患者.5 项肿瘤标志物检测值随着T1、T2、T3 分期而升高,差异均有统计学意义.肺癌经多项指标联合检测所获得的诊断效能各指标数据(敏感度、特异度、准确度、阴性预测值、阳性预测值)分别为 94.84%、98.39%、96.61%、95.02%、98.33%.结论 联合多种肿瘤标志物进行测定不仅能够促进肺癌诊断准确性的提升,而且有助于了解其病理类型与分期,值得推广应用于临床中.
Abstract
Objective To investigate the clinical value of tumor marker detection in the diagnosis of lung cancer.Methods A total of 310 patients with lung cancer treated in Tai'an Cancer Prevention and Control Hospital from July 2020 to July 2022 were selected as lung cancer group,310 patients with benign lung diseases admitted during the same period were included in lung disease group,and 310 healthy physical examiners during the same period were included in healthy control group.The levels of tumor markers were detected in all three groups.The levels of carcinoembryonic antigen(CEA),carbohydrate cancer antigen 125(CA125),cytokeratin 19 fragment(CYFRA21-1),squamous cell carcinoma antigen(SCC)and neurospecific enolase(NSE)were measured using fully automated electrochemiluminescence immunoassay analyzer.The detection results and positive rates of tumor markers in each group werecompared,and the detection results of the above indicators were compared in patients with different pathological types of lung cancer and different tumor stages.Results The positive detection rate of single index and combined detection in lung cancer group was significantly higher than that in lung disease group[CEA(μg/L):10.80±2.34 vs.4.26±0.75;CA125(kU/L):84.79±8.42 vs.29.26±4.07;CYFRA21-1(μg/L):42.14±5.64 vs.2.57±0.53;SCC(μg/L):4.77±1.02 vs.1.30±0.34;NSE(μg/L):25.16±4.38 vs.12.23±2.01;all P＜0.05].The levels of all the indexes in healthy control group were lower than those in other two groups,and the differences were statistically significant.In the lung cancer group,patients with squamous cell carcinoma had the lowest CEA level,and those with adenocarcinoma had the highest CEA level;patients with adenocarcinoma,squamous cell carcinoma and small cell lung cancer had CA125 and CYFRA21-1 levels from high to low;patients with NSE levels from low to high were adenocarcinoma,squamous cell carcinoma and small cell lung cancer;and patients with SCC levels from high to low were squamous cell carcinoma,small cell lung cancer and adenocarcinoma.The test values of five tumor markers increased with T1,T2 and T3 stages,and the differences were statistically significant.The diagnostic efficacy indicators(including sensitivity,specificity,accuracy,negative and positive predictive value)of five tumor markers combined detection for lung cancer diagnosis were 94.84%,98.39%,96.61%,95.02%and 98.33%,respectively.Conclusion The combined determination of multiple tumor markers can not only improve the diagnostic accuracy of lung cancer,but also help to understand its pathological types and stages,which could provide reference for the formulation of clinical treatment.
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