血清TK-1、SE-CAD表达及联合HE4、CEA、CYFRA21-1检测在非小细胞肺癌诊断中的意义
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摘要
目的探讨可溶性E-钙黏蛋白(soluble E-cadherin,SE-CAD)、胸苷激酶-1(thymidine kinase 1,TK-1)在非小细胞肺癌(NSCLC)患者血清中的水平,并分析其与附睾蛋白4(HE4)、癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)联合检测在NSCLC诊断中的临床应用价值。方法收集本院2016年1月至2018年1月期间初诊NSCLC患者86例、小细胞肺癌患者45例、同期良性疾病患者42例、同期初诊其他恶性肿瘤(除肺癌外)患者30例、健康受试者的血清标本40例,应用液态芯片技术对受试者血清标本进行CEA、CYFRA21-1水平检测,ELISA方法检测SE-CAD、TK-1、HE4。结果①非小细胞肺癌患者血清中SE-CAD水平明显高于良性对照组、正常对照组(P<0.05),差异具有统计学意义,但与小细胞肺癌组及其他恶性肿瘤组比较差异无统计学意义(P>0.05);②非小细胞肺癌组患者血清TK1与CYFRA21-1水平明显高于良性对照组、小细胞肺癌组、其他恶性肿瘤组和健康对照组,差异均有统计学意义(均P<0.05)。③单项检测时,CYFRA21-1对非小细胞肺癌的诊断灵敏度最高,为87.2%,TK-1的诊断特异性最高。5种肿瘤标志物联合检测,灵敏度高达93.2%,特异性有所降低为85.7%。结论 SE-CAD、TK1与CYFRA21-1均可作为鉴别良恶性肿瘤的检验指标,联合HE4、CEA、CYFRA21-1等指标对非小细胞肺癌诊断的灵敏度远高于单项检测。
Objective To investigate the levels of soluble E-cadherin(SE-CAD)and thymidine kinase-1(TK-1)in patients with non-small cell lung cancer,and to analyze their diagnosis values when combined with humanepididymisprotein 4(HE4),carcinoembryonic antigen(CEA)and cytokeratin 19(CYFRA21-1)in nonsmall cell lung cancer.Methods From January,2016 to January,2018,86 patients with non-small cell lung cancer,46 patients with small cell lung cancer,42 patients with benign disease,and 30 patients with malignant tumors(except lung cancer)were enrolled in this study.At the same time,40 healthy subjects were chosen as the control group.Serum Levels of CEA and CYFRA21-1 were measured using liquid chip technology,SECAD,TK-1 and HE4 were detected by ELISA.Results ①The level of SE-CAD in the non-small cell lung cancer group was significantly higher than that in the benign control group P<0.05).But no significant difference was observed between the small cell lung cancer group and other malignant tumor groups(P>0.05);②The levels of serum TK1 and CYFRA21-1 in non-small cell lung cancer group were significantly higher than those in the benign control group,small cell lung cancer group,other malignant tumor group and healthy control group(P<0.05).③Among the observed tumor markers,CYFRA21-1 had the highest sensitivity(87.2%),and TK-1 had the highest specificity in the diagnosis of non-small cell lung cancer.The combined detection of 5 tumor markers showed a sensitivity of 93.2% and a specificity of 85.7%.Conclusion SE-CAD,TK1 and CYFRA21-1 could serve as potential diagnostic markers for patients with malignant and benign tumors.When HE4,CEA,CYFRA21-1 were detected combined with SE-CAD and TK1,the sensitivity is much higher than that of any single test.
Objective To investigate the levels of soluble E-cadherin(SE-CAD)and thymidine kinase-1(TK-1)in patients with non-small cell lung cancer,and to analyze their diagnosis values when combined with humanepididymisprotein 4(HE4),carcinoembryonic antigen(CEA)and cytokeratin 19(CYFRA21-1)in nonsmall cell lung cancer.Methods From January,2016 to January,2018,86 patients with non-small cell lung cancer,46 patients with small cell lung cancer,42 patients with benign disease,and 30 patients with malignant tumors(except lung cancer)were enrolled in this study.At the same time,40 healthy subjects were chosen as the control group.Serum Levels of CEA and CYFRA21-1 were measured using liquid chip technology,SECAD,TK-1 and HE4 were detected by ELISA.Results ①The level of SE-CAD in the non-small cell lung cancer group was significantly higher than that in the benign control group P<0.05).But no significant difference was observed between the small cell lung cancer group and other malignant tumor groups(P>0.05);②The levels of serum TK1 and CYFRA21-1 in non-small cell lung cancer group were significantly higher than those in the benign control group,small cell lung cancer group,other malignant tumor group and healthy control group(P<0.05).③Among the observed tumor markers,CYFRA21-1 had the highest sensitivity(87.2%),and TK-1 had the highest specificity in the diagnosis of non-small cell lung cancer.The combined detection of 5 tumor markers showed a sensitivity of 93.2% and a specificity of 85.7%.Conclusion SE-CAD,TK1 and CYFRA21-1 could serve as potential diagnostic markers for patients with malignant and benign tumors.When HE4,CEA,CYFRA21-1 were detected combined with SE-CAD and TK1,the sensitivity is much higher than that of any single test.
引文
[1]何炳虹,陈光辉,潘引鹏,等.肺癌患者手术前后血清TGF-α、TGF_β1和SE_Cad检测的临床意义[J].放射免疫学杂志,2012,25(4):388-389.
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[3]吴伟晴,廖淑萍,王明飞,等.TK1与CEA、CYFRA21-1、NSE、SCC联合检测在肺癌诊断中的意义[J].实用预防医学,2016,23(6):753-754
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[5]蒋贝兰,沙杭.肺癌血清肿瘤标志物的研究现状及进展[J].天津医药,2014,42(4):393-395.
[6]肖伶.血清肿瘤标志物联合检测在肺癌诊断中的意义[J].实用预防医学,2009,16(4):263-265
[7]杜为强,文顺喜.肺癌患者手术治疗前后sE-CAd和血浆可溶性P-选择素联检的临床意义[J].放射免疫学杂志,2005,18(3):227-228.
[8]刘少平,方春华,常城,等.血清可溶性上皮型钙黏附蛋白与胃癌侵袭转移的关系[J].实用医学杂志,2013,29(9):1440-1442.
[9]张剑,董欣敏,吴靖,等.血清人附皋蛋白4在肺癌诊断中的临床应用探讨[J].中华全科医学,2016,14(8):1302-1304.
[10]WANG X,FAN Y,WANG J,et al.Evaluating the expression and diagnostic value of human epididymis protein 4(HE4)in small cell lung cancer[J].Tumour Biol,2014,35(7):6847-6853.
[11]肖然,胡昊昀,王瑞,等.血清肿瘤标志物HE4检测在肺癌诊断中的应用价值探讨[J].检验医学,2014,29(9):893-896.
[2]武彩虹,钱成荣,韩玉成,等.CEA、SCC-Ag、NSE及SE-CAD在肺癌病理分型、分期中的临床价值[J].中国实验诊断学,2016,20(2):240-243.
[3]吴伟晴,廖淑萍,王明飞,等.TK1与CEA、CYFRA21-1、NSE、SCC联合检测在肺癌诊断中的意义[J].实用预防医学,2016,23(6):753-754
[4]支修益,石远凯,于金明.中国原发性肺癌诊疗规范(2015年版)[J].中华肿瘤杂志,2015,37(1):67-78.
[5]蒋贝兰,沙杭.肺癌血清肿瘤标志物的研究现状及进展[J].天津医药,2014,42(4):393-395.
[6]肖伶.血清肿瘤标志物联合检测在肺癌诊断中的意义[J].实用预防医学,2009,16(4):263-265
[7]杜为强,文顺喜.肺癌患者手术治疗前后sE-CAd和血浆可溶性P-选择素联检的临床意义[J].放射免疫学杂志,2005,18(3):227-228.
[8]刘少平,方春华,常城,等.血清可溶性上皮型钙黏附蛋白与胃癌侵袭转移的关系[J].实用医学杂志,2013,29(9):1440-1442.
[9]张剑,董欣敏,吴靖,等.血清人附皋蛋白4在肺癌诊断中的临床应用探讨[J].中华全科医学,2016,14(8):1302-1304.
[10]WANG X,FAN Y,WANG J,et al.Evaluating the expression and diagnostic value of human epididymis protein 4(HE4)in small cell lung cancer[J].Tumour Biol,2014,35(7):6847-6853.
[11]肖然,胡昊昀,王瑞,等.血清肿瘤标志物HE4检测在肺癌诊断中的应用价值探讨[J].检验医学,2014,29(9):893-896.