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《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:

期数:

2020年06期

页码:

777-780

栏目:

论著

出版日期:

2020-12-20

文章信息/Info

Title:

ROC curve analysis of CEA, CY211, NSE and CA125 in the diagnosis of lung cancer

作者:

龚 岚;  罗晓云

214000 江苏,无锡市第二人民医院检验科

Author(s):

Gong Lan;  Luo Xiaoyun.

Department Clinical Laboratory, Wuxi Second People's Hospital, Wuxi, 214000, China

关键词:

支气管肺癌;  癌胚抗原;  细胞角蛋白19片段;  神经元特异性烯醇化酶;  糖类抗原CA125

Keywords:

Lung cancer;  Carcinoembryonic antigen;  Cytokerantin-19-fragment;  Neuron-specific enolase;  Carbohydrate antigen 125

分类号:

-

DOI:

10.3877/cma.j.issn.1674-6902.2020.06.013

摘要:

目的 探讨癌胚抗原(CEA)、细胞角蛋白19片段(CY211)、神经元特异性烯醇化酶(NSE)、糖类抗原125(CA125)联合用于肺癌诊断的价值。方法 选取我院2018年10月至2019年6月收治的肺癌患者140例作为肺癌组,选取同期收治的良性肺病患者136例作为对照组。比较两组血清CEA、CY211、NSE、CA125水平,绘制受试者工作特征曲线(ROC)分析各指标单独与联合检测对肺癌的诊断价值,确定曲线下面积(AUC)、最佳界值与相应的灵敏度、特异度。以病理诊断为金标准,经Kappa检验分析四项指标联合诊断肺癌与病理诊断的一致性,并分析灵敏度、特异度、符合率、阳性预测值、阴性预测值。结果 肺癌组血清CEA、CY211、NSE、CA125含量显著高于对照组(P<0.05)。血清CEA、CY211、NSE、CA125含量诊断肺癌的AUC分别为0.773、0.762、0.753、0.801,四项联合诊断的AUC为0.906。以血清CEA>7.965 ng/ml、CY211>7.960 ng/ml、NSE>28.025 ng/ml、CA125>22.065 U/ml时,发生肺癌风险越高。以病理诊断为金标准,提示四项指标联合诊断肺癌的灵敏度为90.00%,特异度为91.18%,符合率为90.58%,阳性预测值为90.00%,阴性预测值为91.18%,经Kappa检验其与病理诊断一致性为0.812(高度一致性)。结论 与肺良性病者相比,肺癌患者的血清CEA、CY211、NSE、CA125含量明显增高,且四者均对肺癌诊断具有一定价值,四项联合诊断的效果最佳,与病理诊断一致性较好。

Abstract:

Objective To explore the value of CEA, cy211, NSE and CA125 in the diagnosis of lung cancer. Methods 140 patients with lung cancer admitted to our hospital from October 2018 to June 2019 were selected as the lung cancer group, and 136 patients with benign lung disease admitted to our hospital during the same period were selected as the control group. The serum CEA, cy211, NSE and CA125 levels of the two groups were compared, and the working characteristic curve(ROC)of the subjects was drawn to analyze the diagnostic value of each index for lung cancer, and the area under the curve(AUC), the best boundary value, the corresponding sensitivity and specificity were determined. With pathological diagnosis as the gold standard, Kappa test was used to analyze the consistency between the combined diagnosis of lung cancer and pathological diagnosis of the four indicators, as well as the sensitivity, specificity, Coincidence rate, positive predictive value and negative predictive value. Results Serum CEA, CY211, NSE and CA125 levels in lung cancer group were significantly higher than those in control group(P<0.05).The AUC of serum CEA, cy211, NSE and CA125 were 0.773, 0.762, 0.753 and 0.801, respectively. The AUC of combined diagnosis was 0.906.When CEA>7.965 ng/ml, cy211>7.960 ng/ml, NSE>28.025 ng/ml, CA125>22.065 U/ml, the higher the risk of lung cancer. Pathological diagnosis was taken as the gold standard, suggesting that the sensitivity, specificity and coincidence rate of the combined diagnosis of lung cancer with the four indicators were 90.00%, 91.18% and 90.58%, respectively. The positive predictive value and negative predictive value were 90.00% and 91.18% respectively, and the consistency between them and the pathological diagnosis by Kappa test was 0.812(highly consistent). Conclusion Compared with patients with benign lung diseases, serum CEA, CY211, NSE and CA125 in patients with lung cancer were significantly increased, and all the four patients had certain value in lung cancer diagnosis.

参考文献/References:

1 任成山, 钱桂生. 支气管肺癌研究的新思维[J/CD]. 中华肺部疾病杂志(电子版), 2009, 2(3): 143-146.
2 Abbosh C, Birkbak NJ, Wilson GA, et al. Phylogenetic ctDNA analysis depicts early stage lung cancer evolution[J]. Nature, 2017, 545(7655): 446-451.
3 Mak KS, Bommel ACMV, Stowell C, et al. Defining a standard set of patient-centred outcomes for lung cancer[J]. Eur Respir J, 2016, 48(3): 852-860.
4 沈兆坤, 金 昊, 吴 迪, 等. 磨玻璃样影肺癌146例临床诊治分析[J]. 医学临床研究, 2016, 33(10): 2046-2048.
5 倪 军, 郭子健, 张 力. 单独与联合检测四项肺癌血清肿瘤标志物在肺癌诊断中的价值[J]. 中华内科杂志, 2016, 55(1): 25-30.
6 姚梦醒, 赵 卉, 陆友金, 等. TAP及联合肺癌三项肿瘤标记物检测对肺癌的诊断价值[J]. 临床肺科杂志, 2017, 22(6): 988-991.
7 陈 献, 刘静莎, 高红梅, 等. 肺癌肿瘤标志物定量检测的临床价值[J]. 武警医学, 2016, 27(4): 379-381.
8 王强修, 李 钧, 朱良明. 肺癌诊断与治疗[M]. 北京: 人民军医出版社, 2013: 77-79.
9 Fehringer G, Brenner DR, Zhang ZF, et al. Alcohol and lung cancer risk among never smokers: A pooled analysis from the international lung cancer consortium and the SYNERGY study[J]. Int J Cancer, 2017, 140(9): 1976-1984.
10 曾路情, 夏苏建, 彭锐豪, 等. 2006—2016年中国人群肺癌影响因素的Meta分析[J]. 华南预防医学, 2018, 44(5): 37-41.
11 张 欣, 刘连清, 刘英健, 等. 多种指标联合检测对非小细胞肺癌的诊断价值[J]. 中国临床保健杂志, 2016, 19(3): 290-292.
12 张仁锋, 张 岩, 温丰标, 等. 6,058例肺癌患者病理类型和临床流行病学特征的分析[J]. 中国肺癌杂志, 2016, 19(3): 129-135.
13 Aysegül IM, Christian S, Anna SB, et al. Expression profiling of angiogenesis-related genes in brain metastases of lung cancer and melanoma[J]. Tumour Biol, 2016, 37(1): 1173-1182.
14 曹青梅. 血清癌胚抗原与溶血磷脂酸联合检测在非小细胞肺癌诊断中的应用价值[J]. 检验医学与临床, 2016, 13(18): 2579-2581.
15 胡鸿波, 苑凤芹, 赵春玲. 非小细胞肺癌患者化疗前后血清癌胚抗原细胞角蛋白19片段和糖类抗原125的变化[J]. 中国肿瘤临床与康复, 2016, 23(12): 1417-1420.
16 李 玲, 张华茹. 血清癌胚抗原、血管内皮生长因子对非小细胞肺癌病理特征的诊断价值[J]. 中国临床医生杂志, 2017, 45(5): 63-65.
17 Kazuki S, Tetsuya O, Keima I, et al. Predictive role of cyfra21-1 and cea for subsequent docetaxel in non-small cell lung cancer patients[J]. Anticancer Res, 2017, 37(9): 5125-5131.
18 潘桂常, 田东波, 刘坤平, 等. 血清癌胚抗原鳞状细胞癌抗原神经特异型烯醇化酶糖类抗原125与肺癌病理分型及临床特征的关系[J].中国肿瘤临床与康复, 2016, 23(2): 138-142.
19 王 玲, 申 鸿. 癌胚抗原、糖类抗原、CA125、血管生成素、细胞角蛋白19片段及甲胎蛋白检测在肺癌诊断中的临床研究[J]. 陕西医学杂志, 2019, 48(8): 1080-1084.
20 于 溪, 张彬彬, 杨碧洁, 等. 乳酸脱氢酶和神经元特异性烯醇化酶水平与广泛期小细胞肺癌预后的关系[J]. 中国医科大学学报, 2017, 46(5): 425-428.
21 秦文涛, 韩 波. 小细胞肺癌血清NSE及循环肿瘤细胞的相关研究进展[J]. 现代肿瘤医学, 2017, 25(9): 163-166.
22 Toma M, Izumi S, Tawa K. Rapid and sensitive detection of neuron specific enolase with a polydopamine coated plasmonic chip utilizing rear-side coupling method[J]. Analyst, 2017, 143(4): 858-864.
23 许利芳, 胡 克. 血清CEA、SCCA、CYFRA21-1、NSE与血浆D-D联合检测对肺癌诊断的临床意义[J]. 临床肺科杂志, 2017, 22(2): 233-237.
24 杜军华, 乔洪源, 尹宜发. 血清CEA、CA125及Cyfra21-1水平对中晚期非小细胞肺癌患者预后的影响[J]. 肿瘤防治研究, 2016, 43(2): 137-140.
25 李少雷, 马媛媛, 雄 英, 等. 常用血清肿瘤标志物在可手术肺癌患者预后中的价值[J]. 肿瘤防治研究, 2018, 45(1): 24-28.
26 Kataoka Y, Hirano K, Narabayashi T, et al. Carcinoembryonic antigen as a predictive biomarker of response to nivolumab in non-small cell lung cancer[J]. Anticancer Res, 2018, 38(1): 559-563.

备注/Memo

备注/Memo:

基金项目: 南京医科大学科技发展基金重点项目(2017NJMUZD113)
通信作者: 罗晓云, Email: qq597748182@163.com

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更新日期/Last Update: 2020-12-20