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目的:评价血清癌胚抗原(carcinoembryonic antigen,CEA)和细胞角蛋白19的片段(CYFRA21-1)水平对原发性肺癌的诊断价值。方法:回顾性分析2012年5月~2013年5月我科收治的329例肺癌患者和192例肺部良性病变患者的临床资料。结果:肺癌患者血清CEA或CYFRA21-1水平随着肺癌的分期呈现逐渐上升的趋势(P<0.001,P<0.01)。以血清CEA≥3.4μg/L作为诊断条件诊断肺癌的灵敏度、特异度和阳性预计值预计值分别为67%、62%和75.2%;以血清CYFRA-21≥5.0 ug/L作为诊断条件诊断原发性肺癌的灵敏度、特异度和阳性预计值预计值分别为48%、87%和86.3%;以血清CEA≥3.4 ug/L和CYFRA-21≥5.0 ug/L共同作为诊断条件推断原发性肺癌的灵敏度、特异度和阳性预计值预计值分别为48%、87%和86.3%;良性肺部疾病患者中血清CEA和CYFRA-21水平同时升高者只有2%。结论:血清CEA≥3.4 ug/L和CYFRA-21≥5.0 ug/L同时升高对肺癌有具有重要的诊断价值,可有效的鉴别原发性肺癌与其它良性病变。
Objective: To evaluate the diagnostic value of serum carcinoembryonic antigen (CEA) and cytokeratin 19 (CYFRA21-1) levels in primary lung cancer. Methods: The clinical data of 329 patients with lung cancer and 192 patients with benign lung disease who were admitted to our department from May 2012 to May 2013 were retrospectively analyzed. Results: The levels of serum CEA or CYFRA21-1 in patients with lung cancer showed a gradual upward trend with the stage of lung cancer (P <0.001, P <0.01). The predictive value of sensitivity, specificity and positive predictive value for the diagnosis of lung cancer with serum CEA≥3.4μg / L were 67%, 62% and 75.2%, respectively. Serum CYFRA-21≥5.0ug / L was the diagnostic criteria for diagnosis The predictive value of sensitivity, specificity and positive predictive value for patients with lung cancer were 48%, 87% and 86.3%, respectively. The predictive value of serum CEA≥3.4 ug / L and CYFRA-21≥5.0 ug / L as the diagnostic criteria The predictive value of sensitivity, specificity and positive predictive value for lung cancer were 48%, 87% and 86.3%, respectively. Only 2% of patients with benign lung disease had elevated serum CEA and CYFRA-21 simultaneously. CONCLUSION: Simultaneous increase of serum CEA≥3.4 ug / L and CYFRA-21≥5.0 ug / L has important diagnostic value for lung cancer, which can effectively identify primary lung cancer and other benign diseases.