血清CYFRA21 1、NSE、CEA、CA125及SCCA联合检测在肺癌诊断中的价值研究

目的探讨联合检测血清细胞角蛋白19片段(CYFRA21 1)、神经元特异性烯醇化酶(NSE)、癌胚抗原(CEA)、糖类抗原125(CA125)、鳞状上皮细胞癌抗原(SCCA)对肺癌的临床诊断价值。方法选取2018年8月至2019年9月在安徽省胸科医院确诊的肺癌患者109例为肺癌组（腺癌61例，鳞癌30例，小细胞癌18例），肺部良性疾病患者75例为良性肺病组，健康体检者49例为对照组。采用电化学发光法检测各组患者血清中CYFRA21 1、NSE、CEA、CA125及SCCA的表达水平。采用Kruskal Wallis检验、χ2检验比较各组血清CYFRA21 1、NSE、CEA、CA125、SCCA水平和阳性率，采用受试者操作特性曲线（ROC）分析上述5种肿瘤标志物对肺癌的联合诊断价值。结果肺癌组的血清CYFRA21 1、NSE、CEA、CA125、SCCA水平和阳性率明显高于良性肺病组和对照组；腺癌组血清CEA水平高于鳞癌组和小细胞癌组；腺癌组CEA阳性率高于鳞癌组；腺癌组SCCA阳性率高于小细胞癌组；鳞癌组SCCA水平和阳性率高于腺癌组和小细胞癌组；鳞癌组CYFRA21 1水平高于小细胞癌组（P<005）；小细胞癌组NSE水平和阳性率高于腺癌组和鳞癌组，差异均有统计学意义（P<005）。ROC曲线显示5种肿瘤标志物联合检测肺癌及不同病理分型肺癌的ROC曲线下面积（AUC）最大。结论肿瘤标志物CYFRA21 1、NSE、CEA、CA125、SCCA在不同病理分型肺癌中的表达各不相同，联合检测对不同病理分型肺癌的临床诊断价值更大。

Assessment joint detection of CYFRA21-1, NSE,CEA, CA125 and SCCA in the diagnosis of lung cancer

Abstract：Objective To analyze and compare the value of individual andjoint detection ofserum CYFRA21-1, NSE, CEA, CA125 and SCCA in the diagnosis of lung cancer.Method 151 patients with confirmed lung cancer were selected as lung cancer group, 108 patients with benign lung disease as benign lung disease group and 81 healthy people as control group. The levels of CYFRA21-1, NSE, CEA, CA125 and SCCA were detected by electrochemiluminescence. Mann Whitney U test, chi-square test and ROC curve were used to analyze and compare the data of each group. Results The median level and positive rate of CYFRA21-1, NSE, CEA, CA125 and SCCA in lung cancer group were significantly higher than those in benign lung disease group and healthy control group (P<0.05); the level of CEA in lung adenocarcinoma group were higher than those in squamous cell carcinoma group and small cell carcinoma group (P<0.05); the positive rate of CEA in lung adenocarcinoma group were higher than those in squamous cell carcinoma group (P<0.05); the positive rate of SCCA in adenocarcinoma group was higher than that in small cell carcinoma group (P<0.05); the level and positive rate of SCCA in squamous cell carcinoma group were higher than those in adenocarcinoma group and small cell carcinoma group (P<0.05) The level of CYFRA21-1 in SCC group was higher than that in SCC group (P<0.05); the level and positive rate of NSE in SCC group were higher than those in adenocarcinoma group and SCC group (P<0.05). ROC curve showed that AUC of joint detection 5 tumor markers in each group was the highest. Conclusion The expression of tumor markers in different pathological types of lung cancer is different. The combined detection of five tumor markers has a greater clinical value in the diagnosis of lung cancer and different pathological types.