血清CYFRA21－1、SCC－Ag、LDH联合检测对肺鳞癌与肺部感染鉴别诊断的价值初探

摘要

目的:探讨血清SCC－Ag、CYFRA21－1、LDH联合检测对肺鳞癌与肺部感染鉴别诊断的价值.方法:回顾性分析2017年1月至2018年3月北京市和平里医院消化科及呼吸科住院或门诊就诊的110例患者,其中肺鳞癌患者55例,肺部感染患者55例,使用化学发光法和速率法分别检测血清CYFRA21－1、SCC－Ag、LDH表达水平,以及肺鳞癌患者Ⅰ－Ⅳ期CYFRA21－1、SCC－Ag表达水平,经统计学处理后对比分析.结果:肺鳞癌组患者血清CYFRA21－1高于肺部感染组患者,差异有统计学意义(P＜0.05);同时肺部感染组患者血清SCC－Ag表达高于肺鳞癌组,有统计学差异(P＜0.05);Ⅰ期、Ⅱ期肺鳞癌组患者血清CYFRA21－1较Ⅳ期患者相比差异显著,随着肿瘤的进展,血清CYFRA21－1、SCC－Ag均有上升的趋势;肺鳞癌组患者血清LDH表达水平显著高于肺部感染组患者(P＜0.01).结论:独立的每个肿瘤标志物因其自身的特异性和敏感性,可能导致诊断的局限性,血清CYFRA21－1、SCC－Ag、LDH联合检测对肺鳞癌与肺部感染辅助鉴别诊断可能具有一定临床价值.%Objective:To investigate the combined detection value of serum CYFRA21 －1,SCC－Ag and LDH levels in the differential diagnosis of lung squamous cell carcinoma and pneumonia.Methods:A retrospective analysis of 110 patients from January 2017 to March 2018 in the Department of Gastroenterology and Respiratory Medicine of Beijing Hepingli Hospital,including 55 patients with lung squamous cell carcinoma and 55 patients with pneumonia.The levels of serum CYFRA21－1,SCC－Ag,and LDH were measured by chemiluminescence and rate methods.The level of CYFRA21－1,SCC－Ag in stage Ⅰ－Ⅳ of patients with lung squamous cell carcinoma were statistically an-alyzed and compared.Results:The serum CYFRA21 －1 was higher in patients with lung squamous cell carcinoma than that in patients with pneumonia(P＜0.05).Meanwhile,the serum SCC－Ag expression was higher in the pneu-monia group than in the lung squamous cell carcinoma group(P＜0.05).There was a significant difference in serum CYFRA21－1 level between stage Ⅰ+Ⅱ patients compared with stage Ⅳ patients.As the tumor progressed,serum CYFRA21－1 and SCC－Ag levels both increased.Serum LDH levels in patients with lung squamous cell carcinoma were significantly higher than pneumonia groups(P＜0.01).Conclusion:Due to the limitation of each single tumor marker in squamous cell carcinoma diagnosis,the combined detection of serum CYFRA21 －1,SCC－Ag and LDH may have a clinical value in the differential diagnosis of lung squamous cell carcinoma and pneumonia.