摘要
目的探讨肿瘤标志物癌胚抗原(CEA)、细胞角蛋白19可溶性片段(CYFRA21-1)、糖类抗原125(CA125)、血清钙(Ca~(2+))、血清碱性磷酸酶(ALP)水平检测在肺癌骨转移中的临床诊断价值。方法收集确诊的肺癌患者70例(骨转移组32例,无骨转移组38例),检测其血清CEA、CYFRA21-1、CA125、Ca~(2+)和ALP水平,并比较各组间表达水平的差异。结果骨转移组血清CEA、CYFRA21-1、CA125、Ca~(2+)和ALP水平分别为(36.54±10.40)ng/mL、(27.01±8.15)ng/mL、(88.75±18.13)U/mL、(2.55±0.20)mmol/L、(113.25±43.57)U/L,明显高于无骨转移组(25.26±8.15)ng/mL、(21.57±6.92)ng/mL、(67.10±14.86)U/mL、(2.31±0.16)mmol/L、(74.13±36.21)U/L,差异有统计学意义(P<0.05)。多发骨转移组(骨转移数≥2)和单发骨转移组CEA、CA125、Ca~(2+)水平分别为(37.40±9.49)ng/mL vs.(33.49±13.59)ng/mL、(90.83±18.99)U/mL vs.(81.35±13.19)U/mL、(2.54±0.21)mmol/L vs.(2.60±0.11)mmol/L,均明显高于无骨转移组的(25.26±8.15)ng/mL、(67.10±14.86)U/mL、(2.31±0.16)mmol/L,差异有统计学意义(P<0.05)。多发骨转移组CYFRA21-1水平为(28.47±7.60)ng/mL均明显高于单发骨转移组[(21.78±8.45)ng/mL]及无骨转移组[(21.57±6.92)ng/mL],差异有统计学意义(P<0.05)。多发骨转移组ALP为(118.08±44.75)U/L,明显高于无骨转移组(74.13±36.21)U/L,差异有统计学意义(P<0.05)。血清CYFRA21-1诊断肺癌骨转移的灵敏度最高为81.3%,Ca~(2+)特异度最高为89.5%,联合检测5项指标的灵敏度及特异度均较高,分别为93.8%、86.8%。结论单独或联合检测CEA、CYFRA21-1、CA125、Ca~(2+)和ALP水平,对肺癌骨转移有临床诊断价值。
Objective To investigate the clinical diagnostic value of tumor marker carcinoembryonic antigen(CEA),cytokeratin 19 soluble fragment(CYFRA21-1),carbohydrate antigen 125(CA125),serum calcium(Ca~(2+))and serum alkaline phosphatase(ALP)levels in bone metastasis of lung cancer.Methods A total of70 cases of lung cancer(32 cases of bone metastasis and 38 cases of no bone metastasis)were collected and their serum CEA,CYFRA21-1,CA125,Ca~(2+)and ALP,were detected and the different expression levels were compared.Results The levels of serum CEA,CYFRA21-1,CA125,Ca~(2+)and ALP in bone metastasis group were(36.54±10.40)ng/mL,(27.01±8.15)ng/mL,(88.75±18.13)U/mL,(2.55±0.20)mmol/L and(113.25±43.57)U/L,respectively,which were significantly higher than(25.26±8.15)ng/mL,(21.57±6.92)ng/mL,(67.10±14.86)U/mL,(2.31±0.16)mmol/L and(74.13±36.21)U/L of the non-bone metastasis group,there was significant difference(P<0.01).The levels of CEA,CA125 and Ca~(2+)in multiple bone metastasis group(number of bone metastasis≥2)and single bone metastasis group were(37.40 ±9.49)ng/mL vs.(33.49±13.59)ng/mL,(90.83±18.99)U/mL vs.(81.35±13.19)U/mL and(2.54 ±0.21)mmol/L vs.(2.60±0.11)mmol/L,respectively,which were significantly higher than(25.26±8.15)ng/mL,(67.10±14.86)U/mL and(2.31±0.16)mmol/L of the non-bone metastasis group there was significant difference(P<0.05).The level of CYFRA21-1 in the multiple bone metastasis group was(28.47±7.60)ng/mL,which was significantly higher than of the single bone metastasis group[(21.78±8.45)ng/mL]and the boneless metastasis group[(21.57±6.92)ng/mL],there was a significant difference(P<0.05).The ALP of the multiple bone metastasis group was(118.08±44.75)U/L was significantly higher than(74.13±36.21)U/L of the boneless metastasis group,there was significant difference(P<0.05).For the diagnosis of bone metastasis of lung cancer,the serum CYFRA21-1,sensitivity was up to 81.3%and the serum calcium specificity was up to 89.5%.The sensitivity and specificity of the 5 indexes were higher,respectively 93.8% and86.8%.Conclusion The levels of CEA,CYFRA21-1,CA125,Ca~(2+)and ALP are measured alone or in combination,which has clinical diagnostic value for bone metastasis of lung cancer.
引文
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