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目的探讨血清神经元特异性烯醇化酶(neuron specific enolase,NSE)、糖类抗原(carbohydrate antigen,CA)125、癌胚抗原(carcinoembryonic antigen,CEA)、非小细胞肺癌抗原(cytokeratin 19fragment,CYFRA21-1)联合检测对小细胞肺癌(small cell lung cancer,SCLC)的诊断价值。方法 SCLC患者51例(SCLC组)和同期体检健康者25例(对照组),采用电化学发光法检测2组血清NSE、CA125、CEA、CYFRA21-1、CA19-9、CA72-4水平,应用ROC曲线进行分析和评价。结果 SCLC组NSE[(60.22±19.62)μg/L]、CA125[(49.79±9.78)u/mL]、CEA[(6.46±1.02)μg/L]、CYFRA21-1[(3.95±0.85)μg/L]高于对照组[(13.47±4.41)μg/L、(11.49±3.32)u/mL、(1.93±0.75)μg/L、(2.14±0.64)μg/L],差异有统计学意义(P<0.01),SCLC组CA19-9[(15.28±4.39)u/mL]、CA72-4[(2.89±0.36)u/mL]与对照组[(8.42±1.03)u/mL、(1.82±0.41)u/mL]比较差异无统计学意义(P>0.05);血清NSE、CA125、CEA、CYFRA21-1在SCLC组的AUC分别为0.905、0.853、0.778、0.705;ROC曲线分析显示NSE、CA125、CEA、CYFRA21-1的临床诊断临界点分别为23.23μg/L、19.71 u/mL、2.64μg/L、3.24μg/L,单项检测时,NSE、CA125、CEA、CYFRA21-1的灵敏性分别为74.51%、64.71%、64.71%、50.98%,特异性分别为100.00%、96.00%、88.00%、92.00%,4项指标联合检测时灵敏性为94.12%,特异性为84.00%。结论血清NSE是诊断SCLC的一个较理想指标;检测血清NSE、CA125、CEA、CYFRA21-1水平对诊断SCLC有重要意义,4项联合检测灵敏度较单项检测升高,但特异性下降。
Objective To investigate the effects of neuron specific enolase (NSE), carbohydrate antigen (CA) 125, carcinoembryonic antigen (CEA), cytokeratin 19 factor (CYFRA21- 1) combined detection of small cell lung cancer (small cell lung cancer, SCLC) diagnostic value. Methods Twenty-one SCLC patients (SCLC group) and 25 healthy subjects (control group) were enrolled in this study. The serum levels of NSE, CA125, CEA, CYFRA21-1, CA19-9 and CA72-4 were detected by electrochemiluminescence ROC curve analysis and evaluation. Results The serum level of NSE in the SCLC group was significantly higher than that in the control group (60.22 ± 19.62 μg / L), CA125 [49.79 ± 9.78 u / mL], CEA [(6.46 ± 1.02) μg / L], CYFRA21-1 [(3.95 ± 0.85) L was significantly higher than that of the control group [(13.47 ± 4.41) μg / L, (11.49 ± 3.32) u / mL, (1.93 ± 0.75) μg / L, (8.42 ± 1.03) u / mL, (1.82 ± 0.38) u / mL] in CALC group were significantly higher than those in control group [(15.28 ± 4.39) 0.41) u / mL] (P> 0.05). The AUC of serum NSE, CA125, CEA and CYFRA21-1 in SCLC group were 0.905, 0.853, 0.788 and 0.705, respectively. The ROC curve analysis showed that NSE, CA125 CEA and CYFRA21-1 were 23.23μg / L, 19.71u / mL, 2.64μg / L and 3.24μg / L, respectively. The sensitivity of NSE, CA125, CEA and CYFRA21-1 Were 74.51%, 64.71%, 64.71% and 50.98%, respectively. The specificity was 100.00%, 96.00%, 88.00% and 92.00%, respectively. The sensitivity and specificity of the four tests were 94.12% and 84.00% respectively. Conclusions Serum NSE is a more ideal indicator for the diagnosis of SCLC. The detection of serum NSE, CA125, CEA and CYFRA21-1 levels is of great significance for the diagnosis of SCLC. The sensitivity of the four combined tests is higher than that of single test, but the specificity is lower.