摘要
目的:探讨支气管肺泡灌洗液(BALF)中可溶性细胞角蛋白19片段(CYFRA21-1)、神经元特异性烯醇化酶(NSE)和癌胚抗原(CEA)联合检测对肺癌的诊断价值。方法:肺癌患者45例和肺良性病变患者20例(对照组),按照纤维支气管镜操作技术常规取2组对象的BALF,采用免疫放射法检测CYFRA21-1、NSE的水平,采用放射免疫法检测CEA的水平。绘制BALF中CYFRA21-1、NSE和CEA3种标志物的受试者工作特征曲线(ROC),确定临界值,以≥临界值为阳性,计算敏感度、特异度及约登指数。结果:肺癌组BALF中CYFRA21-1、NSE和CEA的最佳临界点值分别为为36.25、7.87和25.91μg/L。3者联合检测串联试验的约登指数为51.7%,高于非联合检测时各单项指标的约登指数(CYFRA21-1为32.1%,NSE为30.0%,CEA为25.6%)。联合检测并联试验的约登指数为40%,但特异度可达100%。结论:BALF中CYFRA21-1、NSE及CEA联合检测可提高肺癌诊断率,降低漏诊率。
Aim：To evaluate the diagnostic value of combined detecting cytokeratin 19 fragment（CYFRA21-1）,neuron specific enolase（NSE） and carcinoembryonic antigen（CEA） in bronchoalveolar lavage fluid（BALF） of patients with lung cancer.Methods：The expressions of CYFRA21-1 and NSE in BAIF of 45 cases of lung cancer and 20 cases of benign lesion were detected by immunoradiometric assay（IRMA）,and CEA was detected by radioimmunoassay（RIA）.Drawing the receive operator characteristic（ROC） curve of CYFRA21-1,NSE and CEA in BALF by the SPSS 10.0 software.Determining the critical point by ROC curve,calculated the sensitivity and specificity and Youden＇s index.Results：The best critical point of CYFRA21-1,NSE and CEA in BALF in lung cancer group was 36.25,7.87,and 25.91 μg/L.The Youden＇ s index of the combined parallel trial in lung cancer grops was higher than that in single marker（51.7% vs 32.2%,30.0%,and 25.6%）,although the specificity decreased to 65.0%.In series trial,the Youden＇s index is 40.0%,but the specificity was up to 100.0%.Conclusion：The combination of three tumor markers in BALF could increase the diagnostic value of lung cancer.
出处
《郑州大学学报（医学版）》
CAS
北大核心
2010年第4期618-621,共4页
Journal of Zhengzhou University(Medical Sciences)
