血清CEA、CA125、NSE水平变化与非小细胞肺癌患者病理特征的关系及联合检测价值分析

doi:10.3969/j.issn.1004-583X.2022.11.005

摘要/Abstract

摘要：

目的分析血清癌胚抗原(CEA)、糖类抗原125(CA125)、神经元特异性烯醇化酶(NSE)水平变化与非小细胞肺癌(NSCLC)患者病理特征的关系及联合检测价值。方法选取2018年1月-2022年1月上海市金山区中西医结合医院收治的NSCLC患者(NSCLC组)175例,另择同期良性肺部病变者(非NSCLC组)180例,比较两组血清CEA、CA125、NSE水平,分析不同分期NSCLC患者血清CEA、CA125、NSE水平,通过Spearman相关性分析法分析血清指标与分期的相关性,绘制受试者工作特征(ROC)曲线分析CEA、CA125、NSE单独检测与联合检测对NSCLC的诊断价值。结果 NSCLC组血清CEA、CA125、NSE水平高于非NSCLC组( $P$ <0.05)。Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期NSCLC患者血清CEA、CA125、NSE水平呈升高趋势,差异有统计学意义( $P$ <0.05)。Spearman相关性分析显示,CEA、CA125、NSE与NSCLC患者临床分期均呈正相关( $r$ =0.579、0.437、0.686, $P$ <0.05)。以NSCLC为阳性,良性肺部病变为阴性,绘制ROC曲线,结果显示,血清CEA、CA125、NSE单独和三者联合检测预测NSCLC的曲线下面积(AUC)分别为0.809、0.842、0.867、0.910( $P$ <0.05)。结论血清CEA、CA125、NSE在NSCLC中表达增加,且随着病情进展呈升高趋势,血清CEA、CA125、NSE单独和联合检测对NSCLC均具有一定诊断价值。

关键词: 癌, 非小细胞肺, 癌胚抗原, 糖类抗原125, 神经元特异性烯醇化酶, 病理特征, 诊断价值

Abstract:

Objective To analyze the relationship between carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), neuron-specific enolase (NSE) and the pathological characteristics of patients with non-small cell lung cancer (NSCLC) and the value of combined detection. Methods Totally 175 NSCLC patients (NSCLC group) who were treated in Shanghai Jinshan District Hospital of Integrated Traditional Chinese and Western Medicine (January 2018-January 2022), and 180 patients with benign pulmonary diseases during the same period (no-NSCLC group) were retrospectively enrolled. The clinical data, the level of CEA, CA125, and NSE of patients at different stages were included as comparators. Spearman correlation analysis was conducted to assess the association between serum indexes and staging system. the diagnostic value of CEA, CA125 and NSE of NSCLC patients, alone and in combination, were analyzed by the receiver operating characteristic (ROC) curve.Results The serum levels of CEA, CA125 and NSE in NSCLC group were markedly higher than those in no-NSCLC group ( $P$ <0.05). The significant increasing trend for serum levels of CEA, CA125 and NSE were found in patients with classification grades Ⅰ-Ⅲ( $P$ <0.05). The results of Spearman correlation analysis showed that CEA, CA125, NSE were positively correlated with the clinical stage of patients with NSCLC ( $r$ =0.579, 0.437, 0.686, $P$ <0.05). The ROC curve was drawn with NSCLC as positive and benign lung disease as negative, the area under the curve (AUC) of CEA, CA125, and NSE for predicting NSCLC, alone and in combination, were 0.809, 0.842, 0.867, and 0.910, respectively ( $P$ <0.05). Conclusion The increased expressions of CEA, CA125 and NSE are detected in NSCLC patients, and increasing trend with the disease progression, the detection of serum levels of CEA, CA125 and NSE alone and in combination had certain diagnostic value for NSCLC.

Key words: carcinoma, non-small-cell lung, carcinoembryonic antigen, carbohydrate antigen 125, neuron-specific enolase, pathological features, diagnostic value

中图分类号:

R730.26

贾成邦, 沈丽娟, 孙志刚. 血清CEA、CA125、NSE水平变化与非小细胞肺癌患者病理特征的关系及联合检测价值分析[J]. 临床荟萃, 2022, 37(11): 992-995.

Jia Chengbang, Shen Lijuan, Sun Zhigang. The relationship between CEA, CA125 and NSE and the pathological characteristics of patients with NSCLC and the value of combined detection[J]. Clinical Focus, 2022, 37(11): 992-995.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2022.11.005

https://huicui.hebmu.edu.cn/CN/Y2022/V37/I11/992

图/表 5

表1 两组血清CEA、CA125、NSE水平比较( x -±s)

组别	例数	CEA (μg/L)	CA125 (U/mL)	NSE (ng/mL)
NSCLC组	175	5.33±1.13	42.57±10.62	20.38±5.10
非NSCLC组	180	3.48±1.41	25.95±7.40	13.71±3.12
$t$ 值		13.618	29.609	14.933
$P$ 值		0.000	0.000	0.000

表1 两组血清CEA、CA125、NSE水平比较( x -±s)

组别	例数	CEA (μg/L)	CA125 (U/mL)	NSE (ng/mL)
NSCLC组	175	5.33±1.13	42.57±10.62	20.38±5.10
非NSCLC组	180	3.48±1.41	25.95±7.40	13.71±3.12
$t$ 值		13.618	29.609	14.933
$P$ 值		0.000	0.000	0.000

表2 NSCLC不同分期患者血清CEA、CA125、NSE水平比较($\bar{x}$±s)

组别	例数	CEA(μg/L)	CA125(U/mL)	NSE(ng/mL)
Ⅰ期	27	3.91±1.05	28.76±4.48	9.36±1.15
Ⅱ期	37	4.59±0.68^*	33.80±3.37^*	12.25±1.17^*
Ⅲ期	44	5.52±0.79^*#	40.43±2.54^*#	14.92±1.18^*#
Ⅳ期	67	6.19±0.58^*#&	54.38±3.55^*#&	17.22±1.16^*#&
$F$ 值		76.027	490.164	343.818
$P$ 值		0.000	0.000	0.000

表2 NSCLC不同分期患者血清CEA、CA125、NSE水平比较($\bar{x}$±s)

组别	例数	CEA(μg/L)	CA125(U/mL)	NSE(ng/mL)
Ⅰ期	27	3.91±1.05	28.76±4.48	9.36±1.15
Ⅱ期	37	4.59±0.68^*	33.80±3.37^*	12.25±1.17^*
Ⅲ期	44	5.52±0.79^*#	40.43±2.54^*#	14.92±1.18^*#
Ⅳ期	67	6.19±0.58^*#&	54.38±3.55^*#&	17.22±1.16^*#&
$F$ 值		76.027	490.164	343.818
$P$ 值		0.000	0.000	0.000

表3 NSCLC患者临床分期与血清CEA、CA125、NSE水平的相关性

指标	NSCLC患者临床分期
指标	$r$ 值	$P$ 值
CEA	0.579	0.012
CA125	0.437	0.023
NSE	0.686	0.004

表3 NSCLC患者临床分期与血清CEA、CA125、NSE水平的相关性

指标	NSCLC患者临床分期
指标	$r$ 值	$P$ 值
CEA	0.579	0.012
CA125	0.437	0.023
NSE	0.686	0.004

表4 CEA、CA125、NSE单独检测与联合检测对NSCLC的诊断价值

指标	AUC值	标准误差	渐进95%置信区间	灵敏度(%)	特异度(%)	诊断阈值
CEA	0.809	0.023	0.764~0.848	70.86	76.54	>4.62
CA125	0.842	0.023	0.799~0.878	69.71	94.97	>32.30
NSE	0.867	0.022	0.827~0.900	72.00	98.32	>11.64
联合检测	0.910	0.015	0.876~0.938	90.86	77.09

表4 CEA、CA125、NSE单独检测与联合检测对NSCLC的诊断价值

指标	AUC值	标准误差	渐进95%置信区间	灵敏度(%)	特异度(%)	诊断阈值
CEA	0.809	0.023	0.764~0.848	70.86	76.54	>4.62
CA125	0.842	0.023	0.799~0.878	69.71	94.97	>32.30
NSE	0.867	0.022	0.827~0.900	72.00	98.32	>11.64
联合检测	0.910	0.015	0.876~0.938	90.86	77.09

图1 CEA、CA125、NSE单独检测与联合检测对NSCLC的诊断价值

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