摘要
目的探究痰液基细胞学检查(sLCT)与血清细胞角蛋白19片段(CYFRA21-1)、癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)联合检测对肺癌的诊断价值。方法选取西南医院确诊的肺癌患者89例为研究对象(鳞癌29例,腺癌20例,小细胞肺癌32例,大细胞癌8例),另取肺部一般性疾病患者50例为对照组。所有患者均进行血清三项肿瘤标志物(CEA,CYFR21-1,NSE)和3次晨痰(sLCT)检测。根据数据分布采用相应统计学方法,运用受试者工作特征ROC曲线综合评价各项指标对肺癌的诊断价值。结果 CEA在肺癌患者中普遍升高,此外,肺鳞癌、腺癌和大细胞癌的血清CYFR21-1水平均高于对照组,小细胞肺癌的血清NSE水平亦高于对照组,差异均有统计学意义(t=2.144~7.467,均P<0.05)。鳞癌的CYFR21-1,腺癌的CEA,小细胞肺癌的NSE均高于其余各组水平,差异均有统计学意义(F=2.54~12.31,P<0.05)。sLCT诊断肺癌灵敏度和特异度分别为0.696和0.960。CEA+CYFR21-1+sLCT组合对肺鳞癌和大细胞癌诊断的ROC曲线下面积最高(AUC分别为0.921和0.897),CEA+CYFRA21-1和CEA+NSE+sLCT组合分别具有诊断肺腺癌和小细胞肺癌的最高ROC曲线下面积(AUC分别为0.853和0.907),且均高于同组其余检测结果(F=2.97~21.22,P<0.05)。结论 CEA是肺癌的广谱标志物,CYFR21-1和NSE可分别作为诊断肺鳞癌与小细胞肺癌的最佳血清指标。sLCT与血清肿瘤标志物联合检测可有效提高中央型肺癌的诊断效能,其中CEA+CYFR21-1+sLCT是诊断肺鳞癌和大细胞癌的最佳组合,CEA+CYFRA21-1和CEA+NSE+sLCT分别是诊断肺腺癌和小细胞肺癌的最佳组合。
Objective To investigate the value of the combined determination of sputum liquid-based cytology(sLCT) and serum cytokeratin 19 fragment(CYFRA21-1),carcinoembryonic antigen(CEA),neuron specific enolase(NSE) for the diagnosis of lung cancers.Methods Collected 89 patients with diagnosed lung cancer as the subject of our study( squamous carcinoma 29 cases,adenocarcinoma 20 cases,small cell lung cancer 32 cases,large cell carcinoma 8 cases) and 50 patients with lung common disease as control group from the Southwest Hospital.They all had to test serum tumor markers(CYFRA21-1,CEA,NSE)and 3 times of sputum liquid-based cytology.Corresponding statistics tests were used according to data distribution,receiver operating characteristic(ROC)curve were used to assess the diagnostic efficiency of each index.Results CEA generally increased in lung cancers,besides,the levels of serum CYFR21-1 in squamous carcinomas,adenocarcinomasand large cell carcinomas were all higher than that of control group,NSE in small cell lung cancers was higher than that of control group(t=2.144~7.467,all P<0.05),respectively.The levels of CYFR21-1 in squamous carcinomas,CEA in adenocarcinomas and NSE in small cell lung cancers were extremely higher than that of any other groups(F=2.54~12.31,all P<0.05),respectively.The sensitivity and specificity of sLCT were 0.696 and 0.960 for diagnosis of lung cancers.The area under ROC curve of CEA+CYFR21-1+sLCT for the diagnosis of squamouscarcinomas and large cell carcinomas was the largest(AUC were 0.921 and 0.897 in turn),the CEA+CYFRA21-1 and CEA+NSE+sLCT had its own largest area under ROC curve for diagnosis of adenocarcinomas and small cell lung cancers respectively(AUC were 0.853 and 0.907 in turn),they were apparently higher than other test indices in same group(F=2.97~21.22,all P<0.05).Conclusion CEA was a broad-spectrum of tumor marker in lung cancers,CYFR21-1 and NSE can be used as best indicators in the diagnosis of squamous carcinomas and small cell lung cancers respectively.The efficiency of diagn
作者
张利祥
潘静
赵洁
叶英姿
李中华
ZHANG Li-xiang;PAN Jing;ZHAO Jie;YE Ying-zi;LI Zhong-hua(Yantai Special Care Center,the Chinese People's Armed Police Force,Shandong Yantai 264000,China;Department of Clinical Laboratory,Southwest Hospital of PLA Army Medical University,Chongqing 400000,China)
出处
《现代检验医学杂志》
CAS
2019年第3期99-103,共5页
Journal of Modern Laboratory Medicine
关键词
肺癌
痰液基细胞学检查
癌胚抗原
细胞角蛋白19片段
神经元特异性烯醇化酶
lung cancer
sputum liquid-based cytology test
carcinoembryonic antigen(CEA)
cytokeratin 19 fragment(CYFRA21-1)
neuron specific enolase(NSE)
