联合检测NSCLC患者血清中HE4、CYFRA21-1和TPS的表达水平对NSCLC早期诊断的临床价值

摘要

目的 探讨联合检测NSCLC患者血清中HE4、CYFRA21-1和TPS的表达水平对NSCLC早期诊断的临床价值.方法 选取2015年12月至2016年12月我院收治的原发性NSCLC患者97例作为NSCLC研究组,同期收治的92例肺部良性病变或肺炎患者作为良性对照组,以及同期来我院体检的健康者90例作为健康对照组,分别应用电化学发光免疫分析法和ELISA法检测三组血清中HE4、CYFRA21-1和TPS的表达水平,比较三组间这三种肿瘤标志物与病理类型和临床分期的关系,以及单项检测和联合检测诊断NSCLC的敏感性和特异性.结果 NSCLC研究组的血清HE4、CYFRA21-1和TPS的表达水平显著高于良性对照组和健康对照组 (P<0.05);腺癌患者血清CYFRA21-1表达水平显著低于鳞癌和腺鳞癌,Ⅰ-Ⅱ期NSCLC患者的血清HE4表达水平显著高于良性对照组(P<0.05),Ⅲ和Ⅳ期患者血清HE4、CYFRA21-1和TPS表达水平均显著高于Ⅰ-Ⅱ期患者(P<0.05);血清HE4、CYFRA21-1和TPS三种指标联合检测诊断NSCLC的敏感性明显升高,与单项检测的敏感性相比,差异具有统计学意义(P <0.05).结论 联合检测血清 HE4、CY-FRA21-1和TPS的表达水平较检测单项指标对于NSCLC早期诊断具有更高的诊断价值.%Objective To investigate the clinical value of serum levels of HE4,CYFRA21-1 and TPS in early di-agnosis of patients with NSCLC. Methods 97 patients with primary NSCLC from December 2015 to December 2016 were selected as the NSCLC group,92 patients with benign lung lesions or pneumonia treated as the benign control group,and 90 physical examination cases as the healthy control group. The expression levels of HE4, CYFRA21-1 and TPS in serum were detected by electrochemiluminescence assay and ELISA, respectively. The relationship be-tween the three tumor markers and the pathological type and clinical stage was analyzed,and the sensitivity and spe-cificity of single detection and combined detection were compared. Results The levels of HE4, CYFRA21-1 and TPS in the NSCLC group were significantly higher than those in the benign control group and the healthy control group (P<0.05). The level of serum CYFRA21-1 in adenocarcinoma was significantly lower than that in squamous cell carcinoma and adenosquamous carcinoma. The level of serum HE4 expression in patients with stage Ⅰ-Ⅱ NSCLC was significantly higher than that in the benign control group (P<0.05). The levels of serum HE4, CYFRA21-1 and TPS in patients with stageⅢandⅣwere significantly higher than those in stage I-Ⅱ(P<0.05). The sensitivi-ty of HE4,CYFRA21-1 and TPS combined test to diagnose NSCLC was significantly higher than that of the control group (P<0.05). Conclusion The combined detection of HE4, CYFRA21-1 and TPS in serum for NSCLC early diagnosis showed higher diagnostic value than the single detection.