吉林大学学报(医学版) ›› 2018, Vol. 44 ›› Issue (05): 1020-1024.doi: 10.13481/j.1671-587x.20180524

• 临床研究 • 上一篇    下一篇

肿瘤标志物SCC-Ag、CEA、CYFRA21-1和D-二聚体联合检测对非小细胞肺癌的早期诊断价值

孙洪帅, 朱华, 高海燕, 万广财, 于秀艳   

  1. 吉林省肿瘤医院检验科, 吉林 长春 130012
  • 收稿日期:2017-11-23 出版日期:2018-09-28 发布日期:2018-11-20
  • 通讯作者: 于秀艳,主任技师(Tel:0431-85871048,E-mail:66680495@qq.com) E-mail:66680495@qq.com
  • 作者简介:孙洪帅(1983-),男,吉林省长春市人,主管技师,主要从事生化和免疫学方面的研究。
  • 基金资助:
    国家高技术研究发展计划(863计划)项目资助课题(2011AA02A111)

Value of combined detection of tumor markers SCC-Ag, CEA, CYFRA21-1 and D-dimer in early diagnosis of non-small cell lung cancer

SUN Hongshuai, ZHU Hua, GAO Haiyan, WAN Guangcai, YU Xiuyan   

  1. Department of Clinical Laboratory, Jilin Provincial Tumor Hospital, Changchun 130012, China
  • Received:2017-11-23 Online:2018-09-28 Published:2018-11-20

摘要: 目的:探讨肿瘤标志物鳞状细胞癌抗原(SCC-Ag)、癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)和D-二聚体(D-D)在非小细胞肺癌(NSCLC)患者体内的表达水平,阐明其对NSCLC早期诊断的临床价值。方法:选取NSCLC患者200例(NSCLC组)、肺部良性病变患者198例(肺部良性病变组)和健康体检者196名(对照组)作为研究对象,检测静脉血血清中SCC-Ag、CEA、CYERA21-1和D-D水平,并进行组间比较。绘制受试者工作特征曲线(ROC曲线)分析各肿瘤标志物、D-D水平以及联合指标在NSCLC患者中的诊断价值。结果:NSCLC组患者各肿瘤标志物及D-D水平均明显高于肺部良性病变组和对照组(P<0.01);肺腺癌患者CEA水平高于肺鳞癌患者(P=0.005),肺鳞癌患者SCC-Ag和CYFRA21-1水平高于肺腺癌患者(P=0.008,P=0.004);Ⅲ-Ⅳ期NSCLC患者CEA、CYFRA21-1和D-D水平明显高于Ⅰ-Ⅱ期NSCLC患者(P<0.05)。ROC曲线,单项检测中,SCC-Ag的曲线下面积(AUC)最大(AUC=0.805),其灵敏度和特异度分别为85.42%和64.21%,联合指标的诊断效能优于各单项指标(AUC=0.933),其灵敏度和特异度分别为86.46%和88.42%。结论:肿瘤标志物SCC-Ag、CEA、CYFRA21-1和D-D联合检测可明显提高NSCLC早期诊断的灵敏度和特异度,其对NSCLC早期诊断具有重要意义。

关键词: 癌,非小细胞肺, 肿瘤标志物, D-二聚体, 受试者工作特征曲线

Abstract: Objective:To investigate the expression levels of tumor markers squamous cell carcinoma antigen (SCC-Ag), carcinoembryonic antigen(CEA), cytokeratin 19 fragment(CYFRA21-1)and D-dimer(D-D) of the patients with non-small cell lung cancer(NSCLC), and to elucidate its clinical value in the early diagnosis of NSCLC. Methods:A total of 200 patients with NSCLC(NSCLC group), 198 patients with benign lung disease(benign lung disease group) and 196 healthy subjects(control group) were selected and the levels of tumor markers and D-D were detected and compared between groups. The receiver operator characteristic curve (ROC) was drawn to analyze the diagnostic values of different tumor markers, D-D, and joint indicators in the patients with NSCLC. Results:The levels of tumor markers and D-D of the patients in NSCLC group were significantly higher than those in benign lung disease group and control group (P<0.01). The level of CEA in lung adenocarcinoma was higher than that in lung squamous cell carcinoma (P=0.005). The levels of SCC-Ag and CYFRA21-1 in lung squamous cell carcinoma were higher than those in lung adenocarcinoma (P=0.008, P=0.004). The levels of tumor markers CEA, CYFRA21-1 and D-D of the patients with stage Ⅲ and Ⅳ NSCLC were significantly higher than those of the patients with stage Ⅰ and Ⅱ NSCLC (P<0.05). The ROC curves showed that area under curve(AUC)of SCC-Ag was higher than other single indexes(AUC=0.805);the sensitivity and specificity were 85.42% and 64.21%, respectively. The diagnostic efficacy of the joint indicators was better than that of each single index (AUC=0.933);the sensitivity and specificity were 86.46% and 88.42%, respectively. Conclusion:Combined detection of tumor markers SCC-Ag, CEA, CYFRA21-1 and D-D can significantly increase the sensitivity and specificity of early diagnosis of NSCLC and has important significance in the early diagnosis of NSCLC.

Key words: carcioma,non-small cell lung, tumor markers, D-dimer, receiver operatating characteristic curve

中图分类号: 

  • R331