血清癌胚抗原、神经元特异性烯醇化酶、microRNA-20a和microRNA-210联合检测对早期小细胞肺癌的诊断价值
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摘要
目的探讨血清癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、microRNA-20a (miRNA-20a)和microRNA-210(miRNA-210)联合检测对早期小细胞肺癌(SCLC)的诊断价值。方法选择2016年6月至2017年5月秦皇岛市第二医院收治的60例早期SCLC患者作为观察组,另选择同期体检健康者30例作为对照组,采用双抗体夹心法检测血清CEA水平,采用化学发光分析法检测血清NSE水平,采用实时荧光定量聚合酶链反应检测miRNA-20a、miRNA-210的表达量,采用受试者工作特征曲线分析单项及血清CEA、NSE、miRNA-20a和miRNA-210联合检测对早期SCLC的诊断价值。结果观察组患者血清CEA、NSE、miRNA-20a及miRNA-210水平显著高于对照组(P<0.05)。血清miRNA-20a诊断早期SCLC的敏感度显著高于血清CEA、NSE和miRNA-210(P<0.05),血清NSE诊断早期SCLC的特异度高于血清CEA、miRNA-20a和miRNA-210(P<0.05),4项指标联合检测诊断早期SCLC的敏感度、特异度、阳性预测值和阴性预测值显著高于单个指标检测、2项指标联合检测及3项指标联合检测(P<0.05)。结论CEA、NSE、miRNA-20a和miRNA-210联合检测对SCLC的早期诊断具有较高的临床价值。
Objective To investigate the diagnostic value of combined detection of serum carcinoembryonic antigen(CEA),neuron-specific enolase(NSE),microRNA-20a(miRNA-20a) and microRNA-210(miRNA-210) in early small cell lung cancer(SCLC). Methods Sixty early SCLC patients admitted to the Second Hospital of Qinhuangdao from June 2016 to May 2017 were selected as observation group,and thirty healthy person in the same period were selected as control group. The level of serum CEA was detected by double antibody sandwich method,and the level of serum NSE was detected by chemiluminescence analysis. The expression of miRNA-20a and miRNA-210 was detected by real-time quantitative polymerase chain reaction. The diagnostic value of single detection and combined detection of serum CEA,NSE,miRNA-20a and miRNA-210 in early SCLC was analyzed by receiver operating characteristic curve. Results The levels of serum CEA,NSE,miRNA-20a and miRNA-210 in the observation group were significantly higher than those in the control group(P<0.05). The sensitivity of serum miRNA-20a in diagnosing early SCLC was significantly higher than that of serum CEA,NSE and miRNA-210(P<0.05). The specificity of serum NSE in diagnosing early SCLC was higher than that of serum CEA,miRNA-20a and miRNA-210(P<0.05). The sensitivity,specificity,positive predictive value and negative predictive value of combined detection of the four indicators in diagnosing early SCLC were significantly higher than those of single indicator detection,combined detection of two indicators and combined detection of three indicators(P<0.05). Conclusion The combined detection of CEA,NSE,miRNA-20a and miRNA-210 has high diagnostic value for early SCLC.
Objective To investigate the diagnostic value of combined detection of serum carcinoembryonic antigen(CEA),neuron-specific enolase(NSE),microRNA-20a(miRNA-20a) and microRNA-210(miRNA-210) in early small cell lung cancer(SCLC). Methods Sixty early SCLC patients admitted to the Second Hospital of Qinhuangdao from June 2016 to May 2017 were selected as observation group,and thirty healthy person in the same period were selected as control group. The level of serum CEA was detected by double antibody sandwich method,and the level of serum NSE was detected by chemiluminescence analysis. The expression of miRNA-20a and miRNA-210 was detected by real-time quantitative polymerase chain reaction. The diagnostic value of single detection and combined detection of serum CEA,NSE,miRNA-20a and miRNA-210 in early SCLC was analyzed by receiver operating characteristic curve. Results The levels of serum CEA,NSE,miRNA-20a and miRNA-210 in the observation group were significantly higher than those in the control group(P<0.05). The sensitivity of serum miRNA-20a in diagnosing early SCLC was significantly higher than that of serum CEA,NSE and miRNA-210(P<0.05). The specificity of serum NSE in diagnosing early SCLC was higher than that of serum CEA,miRNA-20a and miRNA-210(P<0.05). The sensitivity,specificity,positive predictive value and negative predictive value of combined detection of the four indicators in diagnosing early SCLC were significantly higher than those of single indicator detection,combined detection of two indicators and combined detection of three indicators(P<0.05). Conclusion The combined detection of CEA,NSE,miRNA-20a and miRNA-210 has high diagnostic value for early SCLC.
引文
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[2]TOKAR T,PASTRELLO C,RAMNARINE V R.Differentially expressed microRNAs in lung adenocarcinoma invert effects of copy number aberrations of prognostic genes[J].Oncotarget,2018,9(10):9137-9155.
[3]张兵林,笪冀平.WHO(2015)肺肿瘤组织学分类解读[J].诊断病理学杂志,2016,23(6):401-405,410.
[4]夏贤斌,李坚,汪毅.血浆miRNA-20a和miRNA-210对肺癌的诊断价值评价[J].江苏大学学报(医学版),2017,27(1):47-52.
[5]卢兴兵,石佳,李勤,等.血清肿瘤志物在诊断转移性肺癌中的临床价值[J].检验医学与临床,2018,15(2):179-182.
[6]黄雪娉.cyfr21-1、NSE和CEA联合检测在肺癌早期诊断及肺癌病理类型鉴别中的应用[J].国际检验医学杂志,2015,36(12):1728-1729,1732.
[7]丁珂,滕毅.血清CEA、NSE与CYFRA21-1联合检测在肺癌诊断及疗效评估中的价值[J].贵州医科大学学报,2017,42(7):803-807.
[8]罗和生,万一圆,黄晓东.微小RNA在恶性肿瘤诊断与治疗中的研究进展[J].新乡医学院学报,2018,35(12):1134-1138.
[9]PRATAP P,RAZA S T,ABBAS S,et al.MicroRNA-associated carcinogenesis in lung carcinoma[J].J Cancer Res Ther,2018,14(2):249-254.
[10]吴振永.微小核糖核酸(miRNA)联合C反应蛋白检测对肺癌早期的诊断价值[J].实用癌症杂志,2017,32(7):1062-1064.
[11]王鑫,张毅,胡牧,等.血浆微RNA对早期非小细胞肺癌诊断价值的临床研究[J].肿瘤研究与临床,2017,29(7):442-446,452.