肿瘤标志物联合检测在肺癌中的诊断价值

目的探讨癌胚抗原（CEA）、神经特异性烯醇化酶（NSE）、糖类抗原19-9（CA19-9）、细胞角蛋白19片断21-1（CYFRA21-1）、糖类抗原125（CA125）、糖类抗原724（CA724）以及糖类抗原A50（CA50）等7种肿瘤标志物联合检测在肺癌中的诊断价值。方法应用电化学发光免疫分析及免疫放射分析法检测66例肺癌、48例肺良性疾病患者血清上述7种肿瘤标志物水平,通过ROC曲线和logistic回归法分析7种肿瘤标志物与肺癌的关系,并分析各单项检测及联合检测的灵敏度（Se）、特异度（Sp）、准确度（Ac）等。结果两组CA50含量比较差异无统计学意义（P〉0.05）,其余6种肿瘤标志物肺癌组均高于肺良性病变组,差异均有统计学意义（P〈0.01）。CEA、CA125、NSE、CYFRA21-1的ROC曲线下面积（AZ）〉0.75,诊断肺癌的价值较高。logistic回归系数的z检验表明CEA、NSE、CYFRA21-1、CA724与肺癌的发病有显著相关（P〈0.05）。采用对肺癌的诊断价值和灵敏度较高的CEA、NSE、CYE21-1进行联合检测,三者联合检测的灵敏度达到100%,准确度80.7%,阴性预测值100%。结论联合检测CEA、Cyfra21-1、NSE可显著提高肺癌诊断的临床价值,优于单项检测,为肺癌诊断提供有力依据。

Diagnostic Value of the Combined Tests in the Lung Cancer

Objective To study the diagnostic value of the combined detection of CEA,NSE,CA19-9,CYFRA 21-1,CA125,CA724 and CA50 in the lung cancer.Methods The levels of seven tumor markers were measured in 66 cases of lung cancer and 48 patients with benign lung disease were detected by electrochemical luminescence immunoassay and immunoradiometric assay.The area under the ROC curve（AZ）and logistic regression analysis of the levels of seven tumor markers were compared.Results The levels of serum CEA,NSE,CA19-9,CYFRA 21-1,CA125 and CA724 in lung cancer group were significant different from benign group（P0.01）.The AZ of CEA,CA125,NSE,CYFRA 21-1 were greater than 0.75.Logistic regression coefficient of z test showed that CEA,NSE,CYFRA 21-1,CA724 and lung cancer were significantly related（P0.05）.The sensitivity of combination with CEA,NSE and CYE21-1 was higher than any sensitivity of CEA,NSE or CYE21-1 alone.The sensitivity of joint detection achieved 100%.Conclusion The combined detection of CEA,CYFRA 21-1 and NSE promote distinctively the diagnostic value of lung cancer patients which will provide a scientific and reliable evidence for diagnosis of lung cancer.