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目的探讨血清肿瘤标志物细胞角蛋白19片段(CYFRA21-1)、鳞状上皮细胞癌抗原(SCC-Ag)、癌胚抗原(CEA)及糖类抗原125(CA125)联合检测在非小细胞肺癌诊断中的价值。方法用化学发光法检测157例非小细胞肺癌患者(鳞癌85例、腺癌72例,非小细胞肺癌组)、89例肺部良性疾病患者(肺部良性疾病组)及50例健康人(健康对照组)血清中CYFRA21-1、SCC-Ag、CEA及CA125的含量,并对其敏感性和特异性进行分析。结果非小细胞肺癌组血清肿瘤标志物CYFRA21-1、SCC-Ag、CEA、CA125水平均明显高于肺部良性疾病组及健康对照组,差异均有统计学意义(P<0.01)。非小细胞肺癌组患者血清CYFRA21-1、SCC-Ag、CEA及CA125阳性率明显高于肺部良性疾病组及健康对照组,差异均有统计学意义(P<0.01),敏感性分别为59.8%、26.8%、52.9%及61.1%;CYFRA21-1和SCC-Ag对肺鳞癌、CEA和CA125对肺腺癌的敏感性较高,分别达到71.7%、41.2%及72.2%、79.2%,分别高于对另一类型肺癌的敏感性,差异均有统计学意义(P<0.01)。各指标单检对非小细胞肺癌诊断的敏感性分别为59.9%、26.8%、52.9%及61.1%,4项联合检测敏感性为89.8%,明显高于单项指标检测,差异具有统计学意义(P<0.01)。结论血清CYFRA21-1、SCC-Ag、CEA及CA125联合检测可提高非小细胞肺癌诊断的敏感性,并有助于非小细胞肺癌的初步分型。
Objective To investigate the diagnostic value of serum cytokeratin 19 (CYFRA21-1), squamous cell carcinoma antigen (SCC-Ag), carcinoembryonic antigen (CEA) and carbohydrate antigen 125 (CA125) in non-small cell lung cancer Diagnostic value. Methods 157 patients with non-small cell lung cancer (85 squamous cell carcinoma, 72 adenocarcinoma, non-small cell lung cancer), 89 benign pulmonary disease (benign lung disease group) and 50 healthy people (Healthy control group) serum CYFRA21-1, SCC-Ag, CEA and CA125 content, and its sensitivity and specificity were analyzed. Results The levels of serum tumor markers CYFRA21-1, SCC-Ag, CEA and CA125 in non-small cell lung cancer were significantly higher than those in benign lung disease and healthy controls (P <0.01). The positive rates of serum CYFRA21-1, SCC-Ag, CEA and CA125 in non-small cell lung cancer patients were significantly higher than those in benign lung diseases and healthy controls (P <0.01), and the sensitivity rates were 59.8 %, 26.8%, 52.9% and 61.1%, respectively. CYFRA21-1 and SCC-Ag had a higher sensitivity to lung adenocarcinoma of lung squamous cell carcinoma, CEA and CA125, reaching 71.7%, 41.2% and 72.2%, 79.2% Respectively, higher than the sensitivity of another type of lung cancer, the difference was statistically significant (P <0.01). The sensitivity of single index test for the diagnosis of non-small cell lung cancer was 59.9%, 26.8%, 52.9% and 61.1%, respectively. The sensitivity of the four combined tests was 89.8%, which was significantly higher than that of the single index test, the difference was statistically significant P <0.01). Conclusion The combination of serum CYFRA21-1, SCC-Ag, CEA and CA125 can improve the sensitivity of non-small cell lung cancer diagnosis and contribute to the initial classification of non-small cell lung cancer.