1 衡水市第二人民医院检验科，河北 衡水 053000
2 衡水市第五人民医院检验科，河北 衡水 053000
3 衡水市第二人民医院肿瘤科，河北 衡水 053000
目的：观察血清癌胚抗原(carcinoembryonic antigen，CEA)，糖类抗原19-9(carbohydrate antigen 19-9，CA19-9)，CA125，CA153及细胞角质蛋白片段19(cytokeratin fragment 19，CYFRA21-1)检测对肺癌患者诊断的灵敏度及特异度。方法：回顾性分析2016年1月至2017年6月在衡水市第二人民医院肿瘤科确诊的120例肺癌患者的临床资料，选择同期门诊体检的50例健康者作为对照组。对比各组血清CEA，CA19-9，CA125，CA153和CYFRA21-1水平。结果：肺癌组术前血清CEA，CA19-9，CA125，CA153和CYFRA21-1水平明显高于对照组(P<0.05)；肺癌组术后1 d，7 d，1个月及3个月血清CEA，CA19-9，CA125，CA153和CYFRA21-1水平呈逐渐下降趋势(P<0.05)。腺癌患者术前CEA，CA125，CA153水平明显高于鳞癌患者(P<0.05)，鳞癌患者术前CA19-9，CYFRA21-1水平明显高于腺癌患者(P<0.05)。III期患者术前血清CEA，CA19-9，CA125，CA153和CYFRA21-1水平明显高于I期+II期(P<0.05)。有复发、转移患者术前血清CEA，CA19-9，CA125，CA153和CYFRA21-1水平显著高于无复发、转移患者(P<0.05)。ROC曲线结果显示血清CEA，CA19-9，CA125，CA153和CYFRA21-1及5个指标联合检测对肺癌诊断的曲线下面积分别为0.729，0.764，0.744，0.746，0.838，0.937，灵敏度分别为70.00，59.20，60.80，51.70，70.00，84.10，特异度分别为58.00，82.00，80.00，82.00，88.00，96.00。结论：血清CEA，CA19-9，CA125，CA153和CYFRA21-1联合检测可为肺癌的早期筛查、诊断及随访提供重要价值，联合测定又可提高诊断的灵敏度、特异度。关键词： 肺癌；癌胚抗原；糖类抗原19-9；糖类抗原125；糖类抗原153；细胞角质蛋白片段19；诊断；灵敏度；特异度
Sensitivity and specificity of serum CEA, CA19-9, CA125, CA153 and CYFRA21-1 in diagnosis of lung cancer patients
Foundation: This work was supported by the Hengshui Science and Technology Project, China (2017014017z).
Objective: To observe the sensitivity and specificity of serum carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 125 (CA125), carbohydrate antigen 153 (CA153) and cytokeratin fragment 19 (CYFRA21-1) in the diagnosis of lung cancer patients. Methods: The clinical data of 120 patients with lung cancer diagnosed in Hengshui Second Hospital from January 2016 to June 2017 were analyzed retrospectively, and 50 healthy patients who underwent physical examination in the outpatient department during the same period were selected as the control group. The levels of CEA, CA19-9, CA125, CA153 and CYFRA21-1 in serum of each group were compared. Results: Serum CEA, CA19-9, CA125, CA153 and CYFRA21-1 levels in lung cancer group before operation were significantly higher than those in control group (P<0.05). The levels of serum CEA, CA19-9, CA125, CA153 and CYFRA21-1 in lung cancer group decreased gradually after 1 day, 7 days, 1 month and 3 months (P<0.05). The levels of CEA, CA125 and CA153 in patients with adenocarcinoma before operation were significantly higher than those in patients with squamous cell carcinoma (P<0.05), while the levels of CA19-9 and CYFRA21-1 in patients with squamous cell carcinoma before operation were significantly higher than those in patients with adenocarcinoma (P<0.05). Serum CEA, CA19-9, CA125, CA153 and CYFRA21-1 levels in patients with stage III were significantly higher than those in stage I + II (P<0.05). Serum CEA, CA19-9, CA125, CA153 and CYFRA21-1 levels in patients with recurrence and metastasis before operation were significantly higher than those in patients without recurrence and metastasis (P<0.05). ROC curve showed that the area under the curve of CEA, CA19-9, CA125, CA153 and CYFRA21-1 in serum and the combined detection of 5 indexes were 0.729, 0.764, 0.744, 0.746, 0.838 and 0.937, these indexes’ sensitivities were 70.00, 59.20, 60.80, 51.70, 70.00 and 84.10, and their specificities were 58.00, 82.00, 80.00, 82.00, 88.00 and 96.00. Conclusion: Combined detection of serum CEA, CA19-9, CA125, CA153 and CYFRA21-1 can provide important value for early screening, diagnosis and follow-up of lung cancer, and can improve the sensitivity and specificity of diagnosis.Keywords： lung cancer; carcinoembryonic antigen; carbohydrate antigen 19-9; carbohydrate antigen 125; carbohydrate antigen 153; cytokeratin fragment 19; diagnosis; sensitivity; specificity