4项血清肿瘤标志物在肺癌辅助诊断和疗效评估中的价值

doi:10.3969/j.issn.1673-8640.2019.04.009

摘要/Abstract

摘要：

目的探讨癌胚抗原（CEA）、糖类抗原（CA）125、神经元特异性烯醇化酶（NSE）、细胞角蛋白19片段（CYFRA21-1）在肺癌患者化疗疗效评估及临床辅助诊断中的价值。方法选取肺癌患者（肺癌组）86例,根据病理类型分为鳞癌36例、腺癌29例、小细胞癌21例;以体检健康者30名作为正常对照组。检测所有对象血清CEA、CA125、NSE、CYFRA21-1水平。评价4种肿瘤标志物对肺癌的辅助诊断价值及与电子计算机断层扫描（CT）疗效评价的一致性。结果肺癌组血清CEA、CA125、NSE、CYFRA21-1水平明显高于正常对照组（P<0.05）。腺癌患者血清CEA、CA125水平明显高于鳞癌患者和小细胞癌患者（P<0.05）,鳞癌患者CYFRA21-1水平明显高于腺癌患者和小细胞癌患者（P<0.05）,小细胞癌患者NSE水平明显高于腺癌患者和鳞癌患者（P<0.05）。4项血清标志物联合检测辅助诊断肺癌的敏感性、准确性、曲线下面积（AUC）分别为90.63%、87.21%、0.953,明显高于单项检测。CEA、CA125化疗疗效评价与CT的一致性较好（Kappa值分别为0.508、0.470,P<0.001）。结论 CEA、CA125、NSE、CYFRA21-1对肺癌有一定的临床辅助诊断价值。CEA、CA125化疗疗效评价与CT的一致性较好。

关键词: 癌胚抗原, 神经元特异性烯醇化酶, 糖类抗原125, 细胞角蛋白19片段, 肺癌

Abstract:

Objective To investigate the roles of carcinoembryonic antigen（CEA）,carbohydrate antigen （CA） 125,neuron specific enolase（NSE） and cytokeratin-19-fragment（CYFRA21-1） in the auxiliary diagnosis and chemotherapy efficacy evaluation of lung cancer. Methods A total of 86 patients with lung cancer（lung cancer group） were enrolled,which were classified into 36 cases of squamous carcinoma,29 cases of adenocarcinoma and 21 cases of small cell carcinoma,and 30 healthy subjects were enrolled as healthy control group. The levels of CEA,CA125,NSE and CYFRA21-1 were determined. The auxiliary diagnosis efficacy of the 4 serum tumor markers for lung cancer was evaluated,and the consistency with computed tomography（CT） efficacy evaluation was analyzed. Results Serum CEA,CA125,NSE and CYFRA21-1 in lung cancer group were higher than those in healthy control group（P<0.05）. The levels of CEA and CA125 in adenocarcinoma group were higher than those in squamous carcinoma and small cell carcinoma groups（P<0.05）,the levels of CYFRA21-1 in squamous carcinoma group was higher than those in adenocarcinoma and small cell carcinoma groups（P<0.05）,and the level of NSE in small cell carcinoma was higher than those in adenocarcinoma and squamous carcinoma groups（P<0.05）. The sensitivity,specificity and area under receiver operating characteristic（ROC） curve（AUC） of the combined determination of the 4 serum tumor markers were higher than those of their single determinations. CEA and CA125 had good consistencies with CT（Kappa values were 0.508 and 0.470,P<0.001）. Conclusions CEA,CA125,NSE and CYFRA21-1 have auxiliary diagnostic values for lung cancer. The chemotherapy efficacy of CEA and CA125 have good consistencies with CT.

Key words: Carcinoembryonic antigen, Neuron specific enolase, Carbohydrate antigen 125, Cytokeratin-19-fragment, Lung cancer

中图分类号:

R446.1

张丽英, 傅冠华, 吴俊琪. 4项血清肿瘤标志物在肺癌辅助诊断和疗效评估中的价值[J]. 检验医学, 2019, 34(4): 331-334.

ZHANG Liying, FU Guanhua, WU Junqi. Roles of 4 serum tumor markers for the auxiliary diagnosis and efficacy evaluation of lung cancer[J]. Laboratory Medicine, 2019, 34(4): 331-334.

图/表 4

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组别	例数	CEA（ng/mL）	CA125（U/mL）	NSE（ng/mL）	CYFRA21-1（ng/mL）
正常对照组	86	2.46±1.07	16.76±2.33	8.34±2.13	1.73±0.42
肺癌组	30	15.31±5.13	42.51±5.47	16.37±4.20	6.42±1.69
t值		12.409	22.137	10.216	6.144
P值		<0.05	<0.05	<0.05	<0.05

组别	例数	CEA（ng/mL）	CA125（U/mL）	NSE（ng/mL）	CYFRA21-1（ng/mL）
正常对照组	86	2.46±1.07	16.76±2.33	8.34±2.13	1.73±0.42
肺癌组	30	15.31±5.13	42.51±5.47	16.37±4.20	6.42±1.69
t值		12.409	22.137	10.216	6.144
P值		<0.05	<0.05	<0.05	<0.05

病理类型	例数	CEA（ng/mL）	CA125（U/mL）	NSE（ng/mL）	CYFRA21-1（ng/mL）
鳞癌	36	9.28±1.22	32.19±3.17	15.57±2.21	9.22±1.26
腺癌	29	17.42±3.06	54.62±4.22	11.48±2.09	5.81±1.04
小细胞癌	21	8.21±1.13	38.84±3.26	20.85±3.52	4.62±1.13
F值		11.214	16.527	8.106	4.221
P值		<0.05	<0.05	<0.05	<0.05

病理类型	例数	CEA（ng/mL）	CA125（U/mL）	NSE（ng/mL）	CYFRA21-1（ng/mL）
鳞癌	36	9.28±1.22	32.19±3.17	15.57±2.21	9.22±1.26
腺癌	29	17.42±3.06	54.62±4.22	11.48±2.09	5.81±1.04
小细胞癌	21	8.21±1.13	38.84±3.26	20.85±3.52	4.62±1.13
F值		11.214	16.527	8.106	4.221
P值		<0.05	<0.05	<0.05	<0.05

项目	敏感性（%）	特异性（%）	准确性（%）	AUC
CEA	53.13	90.74	76.74	0.843
CA125	43.75	92.59	74.42	0.781
NSE	46.87	88.89	75.00	0.764
CYFRA21-1	62.50	92.59	81.39	0.872
4项联合检测	90.63	85.19	87.21	0.953