肿瘤标志物在肺癌联合诊断的临床应用分析

摘要

目的 研究肺癌病理类型与肿瘤标志物关系及多肿瘤标志物联合检测对肺癌诊断的临床应用价值.方法 回顾性分析该院68例肺癌患者临床资料,研究肺癌病理类型与肿瘤标志物关系,利用方法学指标评价多肿瘤标志物联合检测对肺癌诊断的临床应用价值.结论 肺癌组CEA、CA125、NSE血清水平与异常率与肺良性病变组及对照组比较均有统计学差异(P<0.05),CEA、CA125对腺癌有一定特异性,其血清浓度分别为(68.5±21.5)μg·L-1、(98.5±31.2)U·mL-1与鳞癌、小细胞癌比较有统计学差异(P<0.05),NSE血清浓度小细胞癌较高为(45.5±7.7)μg·L-1与鳞癌、腺癌比较有统计学差异(P<0.05);肺癌组中Ⅰ~Ⅱ期患者CEA、CA125、NSE血清浓度均低于Ⅲ~Ⅳ期患者,两组比较有统计学差异(P<0.05);三种肿瘤标志物灵敏度以CEA 51.5%、特异度以CA125 93.2%较好,联合检测可大幅提高检测的灵敏度(73.5%)及约登指数(0.57).结论 CEA、CA125、NSE对肺癌诊断、疗效观察及肺癌复发的监测均有重要的临床应用价值,三种肿瘤标志物的联合检测可提高肺癌诊断的准确率.%Objective To study the pathological type of lung cancer and tumor markers relations and multi -tumor markers combined detection of clinical value in the diagnosis of lung cancer . Methods A retrospective analysis was made of the clinical data of 68 cases of lung cancer patients in our hospital to study the relationship between the pathological type of lung cancer and tumor markers . We used the methodology to evaluate combined detection of tumor markers in the diagnosis of lung cancer clinical value . Results CEA, CA125, NSE, NSE serum levels and abnormal rate of lung cancer group , benign lung group and control group were significantly different (P < 0. 05 ). CEA, CA125 had to certain specificity adenocarcinoma. Serum concentrations were ( 68. 5 ± 21. 5 ) μg?L-1, ( 98. 5 ± 31. 2) U? mL-1 compared with squamous cell carcinoma , small cell carcinoma with significant difference (P < 0. 05 ). NSE serum concentrations was higher for small cell carcinoma (45. 5 ±1.1) μg?L-1 compared with squamous cell carcinoma ,adenocarcinoma,with a significant difference (P<0.05) ;as for lung cancer group I — II patients CEA,CA125 and NSE serum concentrations were lower than those of III—IV stage patients. The two groups had a significant difference (P < 0.05 ). As for sensitivity of three tumor markers CEA was 51.5%, specificity of CA125 93. 2%. Joint detection can significantly improve the detection sensitivity (73. 5% ) and Youden index (0. 57 ). Conclusion CEA,CA125,NSE have clinical significance for the diagnosis of lung cancer ,curative effect observation and lung cancer recurrence monitoring. Combined test of three kinds of tumor markers in diagnosis of lung cancer can improve the accuracy rate .