国际肿瘤学杂志

国际肿瘤学杂志 ›› 2018, Vol. 45 ›› Issue (6): 337-340.doi: 10.3760/cma.j.issn.1673-422X.2018.06.004

• 论著 • 上一篇    下一篇

血清肿瘤标志物在非小细胞肺癌骨转移中的诊断价值

吴琼，马海洋，王雪臣，张明明，张勇   

  1. 063001 唐山市人民医院放化疗科（吴琼），骨科（马海洋、王雪臣、张勇），胸外科（张明明）  
  • 收稿日期:2017-11-10 出版日期:2018-06-08 发布日期:2018-07-31
  • 通讯作者: 吴琼 E-mail:wuqiong1988888@163.com

Diagnostic value of serum tumor markers in bone metastasis of non-small cell lung cancer

Wu Qiong, Ma Haiyang, Wang Xuechen, Zhang Mingming, Zhang Yong   

  1. Department of Radiation and Chemotherapy, Tangshan People′s Hospital, Tangshan 063001, China
  • Received:2017-11-10 Online:2018-06-08 Published:2018-07-31
  • Contact: Wu Qiong E-mail:wuqiong1988888@163.com

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摘要： 目的 分析血清肿瘤标志物在非小细胞肺癌（NSCLC）骨转移中的诊断价值。方法 回顾性分析2013年3月至2015年9月在唐山市人民医院就诊的160例NSCLC患者的临床资料与随访资料。根据其是否发生骨转移分为观察组和对照组，观察组为发生骨转移的患者114例，对照组为未发生骨转移的患者46例。分别对两组患者血清中的癌胚抗原（CEA）、糖类抗原CA125、糖类抗原CA199、铁蛋白（Ferritin）这4种肿瘤标志物的阳性率、浓度进行分析比较，并分析其对NSCLC骨转移诊断的敏感性和特异性，采用Youden指数综合反映指标的诊断效果。结果 观察组患者血清中的CEA、CA125、CA199、Ferritin浓度分别为（19.74±6.71）μg/L、（45.62±19.53）kU/L、（35.89±15.66）kU/L、（334.02±79.43）μg/L，均高于对照组的（2.36±0.92）μg/L、（14.37±5.43）kU/L、（15.31±7.22）kU/L、（122.58±69.46）μg/L，差异均具有统计学意义（t=7.200，P＜0.001；t=7.180，P＜0.001；t=6.032，P＜0.001；t=11.152，P＜0.001）。观察组患者血清中的CEA、CA125、CA199、Ferritin阳性率分别为78.95%、68.42%、52.63%、73.68%，均高于对照组的8.70%、4.35%、4.35%、13.04%，差异均具有统计学意义（χ2=66.746，P＜0.001；χ2=53.822，P＜0.001；χ2=32.193，P＜0.001；χ2=48.975，P＜0.001）。CEA、CA125、CA199、Ferritin单独检测诊断NSCLC骨转移的敏感性分别为78.94%、68.42%、52.63%和73.68%，特异性分别为91.30%、95.65%、95.65%和86.96%，其Youden指数分别为70.24%、64.07%、48.28%和60.64%。4种肿瘤标志物联合检测诊断NSCLC骨转移的敏感性为99.17%，特异性为72.63%，其Youden指数为71.80%。结论 CEA、CA125、CA199、Ferritin这4种血清肿瘤标志物与NSCLC骨转移具有相关性，且联合检测诊断效果优于单独检测。

关键词: 癌, 非小细胞肺, 肿瘤标记, 生物学, 肿瘤转移, 诊断

Abstract: Objective To analyze the diagnostic value of serum tumor markers in bone metastasis of non-small cell lung cancer (NSCLC). Methods The clinical data and follow up data of 160 patients with NSCLC from March 2013 to September 2015 in Tangshan People′s Hospital were retrospectively analyzed. According to the status of bone metastasis, the patients were divided into the observation group with bone metastasis (n=114) and the control group without bone metastasis (n=46). The positive rates and concentrations of 4 tumor markers including carcinoembryonic antigen (CEA), carbohydrate antigen CA125, CA19-9 and Ferritin were analyzed and compared. And their sensitivities and specificities to the diagnosis of NSCLC bone metastasis were analyzed. The Youden index was calculated to capture the performance of the diagnostic test. Results The concentrations of CEA, CA125, CA19-9 and Ferritin in the observation group were (19.74±6.71) μg/L, (45.62±19.53) kU/L, (35.89±15.66) kU/L and (334.02±79.43) μg/L  respectively, which were higher than those in the control group ［(2.36±0.92) μg/L, (14.37±5.43) kU/L, (15.31±7.22) kU/L, (122.58±69.46) μg/L］, and the differences were statistically significant (t=7.200, P＜0.001; t=7.180, P＜0.001; t=6.032, P＜0.001; t=11.152, P＜0.001). The positive rates of CEA, CA125, CA19-9 and Ferritin in the observation group were 78.95%, 68.42%, 52.63% and 73.68% respectively, which were higher than those in the control group (8.70%, 4.35%, 4.35% and 13.04%), and the differences were statistically significant (χ2=66.746, P＜0.001; χ2=53.822, P＜0.001; χ2=32.193, P＜0.001; χ2=48.975, P＜0.001). The sensitivities of CEA, CA125, CA199 and Ferritin were 78.94%, 68.42%, 52.63% and 73.68% respectively, and the specificities of them were 91.30%, 95.65%, 95.65% and 86.96% respectively. The Youden indexes were 70.24%, 64.07%, 48.28% and 60.64% respectively. The sensitivity and specificity of multifactorial combination were 99.17% and 72.63%, and the Youden index was 71.80%. Conclusion Four tumor markers including CEA, CA125, CA19-9 and Ferritin were correlated with NSCLC, and combined detection has better performance of dignosis than single factor.

Key words: Carnicoma, non-small cell lung, Tumor markers, biological, Neoplasm metastasis, Diagnosis