| 摘要: |
| 目的观察血清细胞角蛋白19片段（CYFRA21-1）、癌胚抗原（CEA）、鳞状细胞癌抗原（SCC）、糖链抗原125（CA125）及糖链抗原19-9（CA19-9）在非小细胞肺癌及其常见病理亚型中的表达状况，探讨联合检测的临床诊断价值。方法应用ECLIA或CLIA法检测CYFRA21-1、CEA、SCC、CA125及CA19-9在490例非小细胞性肺癌（其中腺癌340例、鳞癌150例，I期156例、II期78例、III期122例、IV期134例）及133例肺部良性病变患者血清中的表达，并分析血清CYFRA21-1、CEA、SCC、CA125及CA19-9在非小细胞肺癌不同病理亚型中的表达差异和联合诊断价值。结果非小细胞肺癌组血清CYFRA21-1、CEA、SCC、CA125及CA19-9的中位表达水平均较良性对照组升高（均P＜0.05）。腺癌患者血清CEA的中位表达水平高于鳞癌患者，而鳞癌患者血清CYFRA21-1和SCC的中位表达水平高于腺癌患者（均P＜0.05）。非小细胞肺癌患者5项肿瘤标志物水平与TNM分期密切相关，Ⅲ+Ⅳ期明显高于Ⅰ+Ⅱ期（P＜0.05），分期越晚，5项肿瘤标志物水平越高。5项指标联合检测诊断NSCLC的灵敏度为74.90%，特异度为84.96%，准确度为77.05%，优于各指标的单项检测。CYFRA21-1和CEA联合检测对肺腺癌的诊断价值较佳（灵敏度为60.59%），而CYFRA21-1和SCC联合检测对肺鳞癌的诊断价值较佳（灵敏度为88.67%）。通过logistic回归建立回归模型，CYFRA21-1和CEA联合检测诊断肺腺癌的AUC（0.745）值接近于5项指标联合检测（0.771），而CYFRA21-1和SCC联合检测诊断肺鳞癌的AUC（0.942）值接近于5项联合检测（0.946）。结论血清CYFRA21-1、CEA、SCC、CA125及CA19-9联合检测有助于非小细胞肺癌的临床诊断，其中血清CYFRA21-1和CEA是诊断肺腺癌的理想组合，而血清CYFRA21-1和SCC则是诊断肺鳞癌的理想组合。 |
| 关键词: 血清细胞角蛋白 19 片段 癌胚抗原 鳞状细胞癌抗原 糖链抗原 125 糖链抗原 19-9 非小细胞肺癌 病理
亚型 |
| DOI：10.12056/j.issn.1006-2785.2017.40.1.2017-331 |
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| 基金项目: |
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| Combined detection of serum CYFRA21-1, CEA, SCC, CA125 and CA19-9 in diagnosis of non-small cell lung cancer |
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Zhejiang Hospital
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| Abstract: |
| Objective To evaluate the combined detection of serum CYFRA21-1, CEA, SCC, CA125 and CA19-9 levels in diagnosis of non-small cell lung cancer (NSCLC). Methods Serum specimens from 490 NSCLC patients, including 340 patients with adenocarcinoma, 150 patients with squamous cell lung carcinoma (SCLC) and 133 patients with benign pulmonary disease were collected. Serum levels of CYFRA21-1, CEA, SCC, CA125 and CA19-9 were detected by ECLIA or CLIA. Results The serum levels of CYFRA21-1, CEA, SCC, CA125 and CA19-9 in patients with NSCLC were significantly higher than those with benign pulmonary disease (P＜0.05).The serum CEA level in lung adenocarcinoma patients were significantly higher than that of SCLC, while the CYFRA21-1 and SCC levels in SCLC patients were significantly higher than those of lung adenocarcinoma (P＜ 0.05). The serum levels of 5 markers in patients with stage Ⅲ and Ⅳ were significantly higher those in stageⅠandⅡ(P＜0.05). For
diagnosis of NSCLC the sensitivity of combined detection of five markers was 74.90% , the specificity was 84.96% , and the accuracy was 77.05%. Combined detection of CYFRA21-1 and CEA had better value for the diagnosis of lung adenocarcinoma (the sensitivity was 60.59% ), while combined detection of CYFRA21-1 and SCC had better value for diagnosis of SCLC (the sensitivity was 88.67%). The AUC (0.745) of combination of CYFRA21-1 and CEA for lung adenocarcinoma was close to that of combined detection of 5 markers (0.771), and the AUC (0.942) of combination of CYFRA21-1 and SCC for SCLC was close to combined detection of five markers(0.946). Conclusion Serum CYFRA21-1, CEA, SCC, CA125 and CA19-9 are helpful for clin- ical diagnosis of non-small cell lung cancer. Serum CYFRA21-1 and CEA are the ideal combination for diagnosis of lung adeno- carcinoma, while serum CYFRA21-1 and SCC are the ideal combination for diagnosis of lung squamous cell carcinomas. |
| Key words: CYFRA21-1 CEA SCC CA125 CA19-9 NSCLC Pathological subtype |
