血清NSE、CEA、CA125水平在小细胞肺癌患者诊断和疗效评估中的价值

doi:10.3969/j.issn.1004-583X.2021.03.007

摘要/Abstract

摘要：

目的探讨血清神经元特异性烯醇化酶(NSE)、癌胚抗原(CEA)、糖类抗原125(CA125)水平在小细胞肺癌(SCLC)患者诊断和疗效评估中的价值。方法选取郑州人民医院收治的SCLC患者(SCLC组)48例、非小细胞肺癌患者(NSCLC组)53例,另选取同期在我院体检的正常人作为对照组,分别检测各组血清NSE、CEA、CA125水平;SCLC患者检测化疗后1周、2周、4周的血清NSE、CEA、CA125水平。结果 SCLC组NSE水平明显高于NSCLC组,CEA、CA125水平明显低于NSCLC组(P<0.05);ROC结果显示,NSE、CEA、CA125诊断SCLC的AUC分别为0.825、0.613、0.533,敏感度和特异度分别为77.1%、81.1%,58.3%、66%,89.6%、41.9%;不同TNM分期NSE的水平比较,Ⅳ期>Ⅲ期>Ⅱ期>Ⅰ期(P<0.05),CEA、CA125水平差异无统计学意义(P>0.05);治疗后NSE、CEA水平均明显低于治疗前,治疗后4周<治疗后2周<治疗后1周(P<0.05),CA125水平差异无统计学意义(P>0.05)。结论血清NSE可作为SCLC诊断和临床分期的一项重要肿瘤标志物,同时NSE、CEA对判断SCLC治疗疗效具有重要参考价值。而CA125则在SCLC诊断中特异度低,不适合作为SCLC的肿瘤标志物。

关键词: 小细胞肺癌, 神经元特异性烯醇酶, 癌胚抗原, 抗原, 肿瘤相关, 碳水化合物

Abstract:

Objective To explore the value of the serum neuron-specific enolase(NSE), carcinoembryonic antigen(CEA), and carbohydrate antigen 125(CA125) levels in the diagnosis and efficacy evaluation of patients with small cell lung cancer(SCLC). Methods Forty eight patients with SCLC(SCLC group) and 53 patients with non-small cell lung cancer (NSCLC group) admitted in People's Hospital of Zhengzhou were selected, the normal subjects in physical examination in the hospital during the same period were separately selected and divided into the control group. The serum levels of NSE, CEA and CA125 of patients was tested in all groups respectively, and the serum levels of NSE, CEA and CA125 of SCLC patients in all groups in 1 week, 2 weeks and 4 weeks after chemotherapy were tested. Results NSE level in the SCLC group was significantly higher than that in NSCLC group, and CEA and CA125 levels were significantly lower than NSCLC group (P<0.05). ROC results showed that AUC of NSE, CEA, and CA125 of the diagnosis of SCLC was 0.825, 0.613, 0.533, respectively, and the sensitivity and specificity were 77.1%, 81.1%, 58.3%, 66%, 89.6%, 41.9%, respectively. Compared the level of NSE at different stage of TNM, it satisfied stage Ⅳ> stage Ⅲ> stage Ⅱ> stage Ⅰ (P<0.05). The difference in the level of CEA and CA125 was not significant (P>0.05); the level of NSE and CEA after treatment was significantly lower than that before treatment(P<0.05) (4 w <2 w <1 w), and the difference in the level of CA125 was not significant (P>0.05). Conclusion Serum NSE is eligible to be used as one important tumor marker for diagnosis and clinical staging of SCLC, NSE and CEA are of important reference value for efficacy of SCLC, while CA125 has low specificity in the diagnosis of SCLC and is not suitable as a tumor marker of SCLC.

Key words: small cell lung carcinoma, neuron-specific enolase, carcinoembryonic antigen, antigens, tumor-associated, carbohydrate

中图分类号:

R734.2

杨柯, 陈军. 血清NSE、CEA、CA125水平在小细胞肺癌患者诊断和疗效评估中的价值[J]. 临床荟萃, 2021, 36(3): 225-228.

Yang Ke, Chen Jun. Value of serum NSE, CEA and CA125 levels in diagnosis and efficacy evaluation of patients with small cell lung cancer[J]. Clinical Focus, 2021, 36(3): 225-228.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2021.03.007

https://huicui.hebmu.edu.cn/CN/Y2021/V36/I3/225

图/表 5

参考文献 19

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组别	例数	NSE(ng/ml)	CEA(ng/ml)	CA125(U/ml)
SCLC	48	28.50±9.26^ab	4.57±0.83^ab	51.25±10.47^ab
NSCLC	53	17.25±7.41	6.83±1.23	70.77±17.85a
对照组	40	10.25±2.1	1.59±0.33	29.51±7.91
F值		73.871	194.541	111.113
P值		<0.01	<0.01	<0.01

组别	例数	NSE(ng/ml)	CEA(ng/ml)	CA125(U/ml)
SCLC	48	28.50±9.26^ab	4.57±0.83^ab	51.25±10.47^ab
NSCLC	53	17.25±7.41	6.83±1.23	70.77±17.85a
对照组	40	10.25±2.1	1.59±0.33	29.51±7.91
F值		73.871	194.541	111.113
P值		<0.01	<0.01	<0.01

检验结果变量	AUC	标准误	P值	95%CI		cut-off值	约登指数	敏感度	特异度
检验结果变量	AUC	标准误	P值	下限	上限	cut-off值	约登指数	敏感度	特异度
NSE	0.825	0.042	<0.01	0.742	0.908	23.020	0.582	77.1	81.1
CEA	0.613	0.057	0.050	0.502	0.724	4.285	0.243	58.3	66.0
CA125	0.533	0.048	0.517	0.440	0.627	40.425	0.315	89.6	41.9

检验结果变量	AUC	标准误	P值	95%CI		cut-off值	约登指数	敏感度	特异度
检验结果变量	AUC	标准误	P值	下限	上限	cut-off值	约登指数	敏感度	特异度
NSE	0.825	0.042	<0.01	0.742	0.908	23.020	0.582	77.1	81.1
CEA	0.613	0.057	0.050	0.502	0.724	4.285	0.243	58.3	66.0
CA125	0.533	0.048	0.517	0.440	0.627	40.425	0.315	89.6	41.9

临床分期	例数	NSE	CEA	CA125
Ⅰ期	6	26.05±8.19	4.47±0.78	46.18±13.57
Ⅱ期	8	29.84±9.66^a	4.52±0.81	47.76±14.22
Ⅲ期	14	34.54±10.66^b	4.58±0.84	49.35±14.93
Ⅳ期	20	45.94±14.69^c	4.64±0.87	51.84±15.36
F值		6.262	0.082	0.298
P值		0.001	0.970	0.826