摘要
目的研究螺旋CT联合血清解整合素-金属蛋白酶8(ADAM8)、细胞角蛋白19片段(CYFRA211)以及神经元特异性烯纯化酶(NSE)在肺癌临床诊断中的应用价值。方法将山西省荣军医院2018年2月至2019年12月收治的肺癌患者50例纳入研究,记作肺癌组。另取同期于山西省荣军医院进行诊治或体检的肺部良性病变患者以及健康人员各50例,分别记作肺部良性病变组以及对照组。比较三组人员血清ADAM8、NSE、CYFRA211水平,同时对三组人员进行螺旋CT检查,分析以上指标阳性检出率情况。以受试者工作特征(ROC)曲线分析不同检查方式诊断肺癌的效能。比较肺癌组不同TNM分期患者的血清ADAM8、NSE、CYFRA211水平。结果肺癌组及肺部良性病变组血清ADAM8、NSE及CYFRA211水平分别为(381.69±34.82)ng/L、(255.28±30.48)ng/L,(16.87±3.11)μg/L、(9.27±2.11)μg/L,(13.54±8.10)μg/L、(3.01±1.34)μg/L,均高于对照组的(225.83±24.19)ng/L、(7.42±2.35)μg/L、(1.78±1.02)μg/L(t=5.352、25.994、4.142、17.142、5.165、10.186,均P<0.05),且肺癌组上述各项指标水平均高于肺部良性病变组(t=19.316、14.299、9.069,均P<0.05)。CT联合血清ADAM8、NSE及CYFRA211检测对肺癌的阳性检出率为92.00%,明显高于CT以及血清ADAM8、NSE、CYFRA211单独检测(χ^(2)=7.862、9.000、11.422、9.000,均P<0.05)。经ROC曲线分析可得:CT联合血清ADAM8、NSE及CYFRA211诊断肺癌的曲线下面积0.916、灵敏度0.920以及特异度0.900均高于CT以及血清ADAM8、NSE、CYFRA211单独检测。TNM分期为Ⅲ~Ⅳ期肺癌患者的血清ADAM8、NSE、CYFRA211水平分别为(430.18±36.43)ng/L、(20.05±3.49)μg/L、(15.93±8.22)μg/L,均高于Ⅰ~Ⅱ期患者的(314.72±30.85)ng/L、(12.49±2.67)μg/L、(10.25±6.35)μg/L(t=11.777、8.312、2.644,均P<0.05)。结论螺旋CT联合血清ADAM8、NSE、CYFRA211检测可显著提高肺癌的临床诊断灵敏度、特异度,值得临床推广应用。
Objective To investigate the application value of spiral CT combined with a disintegrin and metalloproteinase 8(ADAM8),neuron-specific enolase(NSE)and cytokeratin 19 fragment(CYFRA21-1)measurements in the clinical diagnosis of lung cancer.Methods Fifty patients with lung cancer who received treatment in Shanxi Rongjun Hospital from February 2018 to December 2019 were included in the lung cancer group.Fifty patients with benign lung disease who concurrently received treatment in Shanxi Rongjun Hospital were included in the benign lung disease group.Fifty 50 healthy controls who concurrently received treatment in Shanxi Rongjun Hospital were included in the control group.Serum levels of ADAM8,NSE and CYFRA211 were compared among the three groups.Three groups received spiral CT scans.ADAM8-,NSE-and CYFRA211-positive detection rates were analyzed.The receiver operating characteristic(ROC)curve was used to analyze the efficacy of different methods in the diagnosis of lung cancer.Serum ADAM8,NSE and CYFRA211 levels in patients with lung cancer at different TNM stages were compared.Results Serum levels of ADAM8,NSE and CYFRA211 in the lung cancer and benign lung disease groups were(381.69±34.82)ng/L,(255.28±30.48)ng/L,(16.87±3.11)μg/L,(9.27±2.11)μg/L,(13.54±8.10)μg/L,(3.01±1.34)μg/L,respectively,which were significantly higher than those in the control group[(225.83±24.19)ng/L,(7.42±2.35)μg/L,(1.78±1.02)μg/L,t=5.352,25.994,4.142,17.142,5.165,10.186,all P<0.05].Serum levels of ADAM8,NSE and CYFRA211 in the lung cancer group were significantly higher than those in the benign lung disease group(t=19.316,14.299,9.069,all P<0.05).The positive detection rate of lung cancer by spiral CT combined with ADAM8,NSE and CYFRA211 measurements was 92.00%,which was significantly higher than that by spiral CT combined with a single detection(χ^(2)=7.862,9.000,11.422,9.000,all P<0.05).The ROC curve analysis revealed that the area under the ROC curve,sensitivity and specificity of the combined method were 0.916,0.920 and 0
作者
张琳
王冠民
任彩芬
张新军
Zhang Lin;Wang Guanmin;Ren Caifen;Zhang Xinjun(Department of Radiology,Shanxi Rongjun Hospital,Taiyuan 030031,Shanxi Province,China;Department of Imaging,General Hospital of Taiyuan Iron and Steel Group Co.,Ltd.,Taiyuan 030008,Shanxi Proince,China;Department of Laboratory Medicine,Taiyuan Central Hospital,Taiyuan 030009,Shanxi Province,China;Department of Radiology,Shouyang People's Hospital,Shouyang 045400,Shanxi Province,China)
出处
《中国基层医药》
CAS
2021年第10期1496-1500,共5页
Chinese Journal of Primary Medicine and Pharmacy
基金
山西省科技攻关项目(20160313015-11)。
