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目的评价血清Cyfra211、CEA及其倍增时间与影像学动态变化对肺癌复发与转移的早期诊断价值。方法 152例肺癌患者,2年内按病情分为3组,稳定组79例,复发组31例,转移组42例。所有对象半年内2～5次测定血清Cyfra211、CEA,同时计算Cyfra211DT、CEADT。采用ROC Curve过程进行多变量ROC曲线分析,并且与各单变量ROC曲线做比较,追踪两年内影像学表现,评价应用Cyfra211、CEA及其倍增时间单独检测和四指标联合检测以及影像学动态变化在诊断肺癌复发与转移中的价值。结果 Cyfra211DT、CEADT在复发和转移中最佳临界值分别为136 d、153 d,143 d,132 d。复发和转移组血清Cyfra211、CEA及其倍增时间与稳定组中灵敏性和特异性存在显著差异。结论 Cy-fra211DT、CEADT优于血清Cyfra211、CEA,四项联检结合影像学动态观察便于肺癌术后复发或转移的早期诊断。
Objective To evaluate the early diagnostic value of serum Cyfra211, CEA, doubling time and dynamic changes of imaging in the recurrence and metastasis of lung cancer. Methods A total of 152 patients with lung cancer were divided into 3 groups according to the disease, 79 patients in stable group, 31 patients in recurrence group and 42 patients in metastasis group. Serum Cyfra211 and CEA were measured in 2 to 5 times within 6 months in all subjects, and Cyfra211DT and CEADT were calculated simultaneously. Multivariate ROC curve analysis was performed by ROC Curve procedure and compared with ROC curve of each univariate. The imaging performance was tracked within two years. Cyfra211, CEA and its doubling time alone and combined with four indexes were detected and the dynamic changes of imaging Diagnostic value of lung cancer recurrence and metastasis. Results The best cutoff values of Cyfra211DT and CEADT in recurrence and metastasis were 136 days, 153 days, 143 days and 132 days respectively. Serum Cyfra211, CEA and their doubling time in recurrence and metastasis group were significantly different from those in stable group. Conclusions Cy-fra211DT and CEADT are better than serum Cyfra211 and CEA in detecting the early postoperative recurrence or metastasis of lung cancer.