MSA、CEA、NLR联合检测对小细胞肺癌的诊断及鉴别诊断效能

摘要

Objective To observe the application value of detection of serum anti-spindle antibodies (MSA),carcinoembryonic antigen (CEA),whole blood neutrophils/lymphocytes (NLR) in diagnosis and differential diagnosis of small cell lung cancer (SCLC).Methods Fifty-three patients with SCLC (SCLC group),33 patients with lung adenocarcinoma (LAC) (LAC group),29 patients with lung squamous cell carcinoma (LSC) (LSC group),16 patients with gastric carcinoma (GC) (GC group),14 patients with hepatic carcinoma (HC) (HC group),13 patients with colorectal cancer (CC) (group CC),12 patients with nasopharyngeal carcinoma (NC) (NC group),and 45 healthy controls (control group) were selected.Serum MSA was detected by indirect immunofluorescence method.Serum CEA was detected by chemiluminescence.Whole blood NLR was measured by electrical impedance method.The sensitivity and specificity of single and combined detection of serum MSA,CEA and whole blood NLR were analyzed.Results Compared with the other groups,the positive rate of serum MSA in the SCLC group was high.Compared with the SCLC group,the positive rates of serum CEA and whole blood NLR in the LAC group were high,while the positive rates of CEA and whole blood NLR in the control group were lower (all P ＜ 0.05).The sensitivity of detecting NLR alone in diagnosis of SCLC was the highest (43.40％),while specificity of detecting MSA alone was the highest (96.58％).The sensitivity of combined detection of MSA + CEA + NLR in diagnosis of SCLC was the highest (in parallel,81.84％),and the specificity was the highest (in series,100.00％).MSA and CEA had higher consistency (κ =0.654),and MSA was moderately consistent with NLR (κ=0.451).Conclusion The combined detection of serum MSA,CEA,and whole blood NLR is helpful for the diagnosis and differential diagnosis of SCLC.%目的 观察血清抗纺锤体抗体(MSA)、癌胚抗原(CEA)及全血中性粒细胞/淋巴细胞(NLR)联合检测对小细胞肺癌(SCLC)的诊断和鉴别诊断效能.方法 SCLC患者53例(SCLC组)、肺腺癌(LAC)患者33例(LAC组)、肺鳞癌(LSC)患者29例(LSC组)、胃癌(GC)患者16例(GC组)、肝癌(HC)患者14例(HC组)、大肠癌(IC)患者13例(IC组)、鼻咽癌(NC)患者12例(NC组),另选健康体检者45例(对照组),采用间接免疫荧光法检测血清MSA,化学发光法检测血清CEA,电阻抗法测算全血NLR,分析MSA、CEA、NLR单独和联合检测诊断SCLC的敏感度、特异度.结果 与其余组比较,SCLC组血清MSA阳性率高;与SCLC组比较,LAC组血清CEA、全血NLR阳性率高,对照组血清CEA、全血NLR阳性率低;P均＜0.05.NLR单独检测诊断SCLC的灵敏度最高(43.40％),MSA单独检测诊断的特异度最高(96.58％).MSA+CEA+NLR三者联合检测诊断SCLC的敏感度(并联,81.84％)、特异度(串联,100.00％)最高.MSA与CEA一致性较高(κ=0.654);MSA与NLR一致性中等(κ=0.451).结论 血清MSA、CEA及全血NLR联合检测有助于SCLC的诊断和鉴别诊断.