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目的:探讨降钙素原(PCT)、C反应蛋白(CRP)、红细胞分布宽度(RDW)及癌胚抗原(CEA)等指标检测对诊断早期肺癌的临床价值。方法:选择早期肺癌128例为观察组,另选择同期在我院健康体检者108例为对照组。采集两组清晨空腹前臂静脉血3.0ml,测定PCT、CRP、RDW及CEA水平,并比较其差异。以对照组为参考线,绘制PCT、CRP、RDW和CEA的ROC曲线,并对ROC曲线结果进行分析。结果:观察组PCT、CRP、RDW及CEA水平均非常显著高于对照组(P<0.01)。以对照组为参考线,PCT、CRP、RDW和CEA的ROC曲线下面积分别为0.697、0.712、0.682和0.735。CEA诊断早期肺癌敏感度为74.4%,PCT诊断早期肺癌敏感度为41.8%;而4种标志物诊断早期肺癌的特异性均在70.8%以上。2种标志物以CEA联合CRP诊断准确度最高,3种标志物以CEA联合PCT、CRP诊断准确度最高,4种标志物联合诊断准确度较2种及3种标志物的准确度虽均不同程度提高,但与CEA联合CRP比较,差异不显著(P>0.05)。结论:PCT、CRP、RDW和CEA对诊断早期肺癌均有一定的临床价值,CEA联合CRP检测可显著提高诊断早期肺癌的准确度。
Objective: To investigate the clinical value of detection of procalcitonin (PCT), C-reactive protein (CRP), distribution width of red blood cells (RDW) and carcinoembryonic antigen (CEA) in the diagnosis of early stage lung cancer. Methods: 128 cases of early lung cancer were selected as the observation group, and the other 108 cases of healthy subjects in our hospital were selected as the control group. Two groups of early fasting forearm venous blood 3.0ml, PCT, CRP, RDW and CEA levels were measured and compared. ROC curves of PCT, CRP, RDW and CEA were drawn from the control group, and the results of ROC curves were analyzed. Results: The levels of PCT, CRP, RDW and CEA in the observation group were significantly higher than those in the control group (P <0.01). Taking the control group as the reference line, the area under the ROC curve of PCT, CRP, RDW and CEA were 0.697, 0.712, 0.682 and 0.735 respectively. The sensitivity of CEA in the diagnosis of early lung cancer was 74.4%, and the sensitivity of PCT in diagnosing early lung cancer was 41.8%. The specificity of CEA in diagnosing early stage lung cancer was above 70.8%. The diagnostic accuracy of CEA combined with CRP was the highest among the two markers. The diagnostic accuracy of CEA combined with PCT and CRP was the highest among the three markers. Although the diagnostic accuracy of the four markers were different from those of two and three markers But there was no significant difference between CEA combined with CRP (P> 0.05). Conclusions: PCT, CRP, RDW and CEA have certain clinical value in the diagnosis of early stage lung cancer. CEA combined with CRP can significantly improve the accuracy of diagnosis of early stage lung cancer.