冯香梅, 王国庆①, 陈 瑛②, 王 蓉, 谷雅君, 刘运德. 血清肿瘤标志物在肺癌诊断中的应用价值*[J]. 中国肿瘤临床, 2010, 37(6): 331-334. DOI: 10.3969/j.issn.1000-8179.2010.06.009
引用本文: 冯香梅, 王国庆①, 陈 瑛②, 王 蓉, 谷雅君, 刘运德. 血清肿瘤标志物在肺癌诊断中的应用价值*[J]. 中国肿瘤临床, 2010, 37(6): 331-334. DOI: 10.3969/j.issn.1000-8179.2010.06.009
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FENG Xiangmei1, WANG Guoqing2, CHEN Ying3, WANG Rong1, GU Yajun1, LIU Yunde1. Diagnostic Value of Serum Tumor Markers for Lung Cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2010, 37(6): 331-334. DOI: 10.3969/j.issn.1000-8179.2010.06.009
Citation: FENG Xiangmei1, WANG Guoqing2, CHEN Ying3, WANG Rong1, GU Yajun1, LIU Yunde1. Diagnostic Value of Serum Tumor Markers for Lung Cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2010, 37(6): 331-334. DOI: 10.3969/j.issn.1000-8179.2010.06.009
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血清肿瘤标志物在肺癌诊断中的应用价值*

Diagnostic Value of Serum Tumor Markers for Lung Cancer

    摘要
  • 摘要: 目的：探讨SCC 、NSE、CEA 、CYFRA21-1 四项肿瘤标志物联合检测对肺癌的诊断价值。方法：采用化学发光法对肺癌组132 例、肺良性疾病组48例和正常对照组92例的血清SCC 、NSE 、CEA 、CYFRA21-1 四项肿瘤标志物进行检测及统计学分析。结果：NSE 、CEA 、CYFRA21-1 在肺癌组显著高于肺良性疾病组和正常对照组，SCC 肺癌组高于正常对照组，CEA 和CYFRA21-1肺良性疾病组显著高于正常对照组。CEA 在肺腺癌中的水平较高，NSE 在小细胞肺癌中的水平较高，而SCC 、CYFRA21-1 在肺鳞癌中的水平较高。单项肿瘤标志物在肺癌诊断中敏感性：NSE>CEA>CYFRA 21-1>SCC；在腺癌中CEA 敏感性最高（58.8%），鳞癌中CYFRA21-1 敏感性最高（71.4%），小细胞肺癌中NSE 敏感性最高（50.0%）。 NSE 、CEA 、CYFRA21-1 的ROC 曲线下面积分别为0.928 ± 0.034、0.957 ± 0.026、0.964 ± 0.023，显示诊断准确性较高。SCC 曲线下面积虽然大于0.5，但差异无统计学意义。肿瘤标志物联合检测，可以提高诊断试验的敏感性，在肺癌诊断中NSE 、CEA 、CYFRA21-1 组合敏感性最高（75.6%），特异性也较好（90.7%）；腺癌诊断中SCC 、NSE 、CEA 组合敏感性最高（73.5%），鳞癌诊断中NSE 、CEA 、CYFRA21-1 组合敏感性最高（75.8%），小细胞肺癌中SCC 、NSE 、CYFRA21-1 组合敏感性最高（75.0%）。 结论：SCC 、NSE 、CEA 、CYFRA21-1 对肺癌的诊断均有一定意义，不同病理类型各有特点，选择合适的组合有利于对肺癌的鉴别诊断。

     

    Abstract: Objective: To investigate the diagnostic value of serum SCC, NSE, CEA, and CYFRA 21-1 for lung cancer patients. Methods:The levels of SCC, NSE, CEA, and CYFRA21-1 were detected by electrochemoluminescence immuno-assay in 132 lung cancer patients, 48patients with benign lung diseases and 92healthy people. Results: The levels of NSE, CEA, and CYFRA21-1 in patients with lung cancer were higher than those in patients with benign lung diseases and in normal controls. The level of SCC in patients with lung cancer was higher than that in normal controls. The levels of CEA and CYFRA21-1 in patients with benign lung disease were higher than those in normal controls. Patients with adenocarci -noma had the highest level of CEA and patients with small cell lung cancer had the highest level of NSE. Patients with squamous cell carcinoma had the highest levels of SCC and CYFRA 21-1. The sensitivity sequence of the tumor markers in lung cancer was: NSE>CEA>CYFRA 21-1>SCC. CEA showed the highest sensitivity of about 58.8% in adenocarcinoma. CYFRA21-1 showed the highest sensitivity of about 71.4% in squamous cell carcinoma. NSE showed the highest sensitivi-ty of about 50% in small cell lung cancer. ROC curves showed that the under-curve area of NSE, CEA, and CYFRA21-1 was 0.928 ± 0.034 , 0.957 ± 0.026 , and 0.964 ± 0.023 , respectively. The combination of NSE, CEA, and CYFRA 21-1 presented with the highest sensitivity (75.6%) and good specificity (90.7%) for the diagnosis of lung cancer. The combination of SCC, NSE, and CEA detection presented with the highest sensitivity (73.5%) for the diagnosis of adenocarcinoma. The combina-tion of NSE, CEA, and CYFRA 21-1 showed the highest sensitivity (87.5%) for the diagnosis of squamous cell carcinoma. The combination of SCC, NSE, and CYFRA 21-1 showed the highest sensitivity (75.0%) for the diagnosis of small cell lung cancer. Conclusion:The assay of SCC, NSE, CEA and CYFRA21-1 is useful for the diagnosis of lung cancer and the ex -pression of the four tumor markers is closely correlated with pathological types. The suitable combination of tumor markers is helpful for differential diagnosis of lung cancer.

     

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