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    血清HE4、VEGF、CYFRA21-1联合检测在非小细胞肺癌诊断中的意义及其与临床病理特征的关系

    The significance of serum HE4, VEGF and CYFRA21-1 in the diagnosis of non-small cell lung cancer and their relationship with clinicopathological features

      摘要
    • 摘要: 目的 探讨血清肿瘤标志物人附睾蛋白4(HE4)、血管内皮细胞生长因子(VEGF)、细胞角蛋白19片段(Cytokeratin-19-fragment, CYFRA21-1)联合检测在非小细胞肺癌(NSCLC)中的诊断价值及其水平与NSCLC临床病理特征的关系。方法 采用酶联免疫吸附法(ELISA法)分别检测60例原发性NSCLC患者、55例肺良性病变或肺炎患者、55例健康体检者血清HE4、VEGF、CYFRA21-1的表达水平,并进行分析。结果 NSCLC组的血清HE4、VEGF、CYFRA21-1的水平均显著高于肺良性病变组和健康对照组(P<0.05)。临床分期Ⅲ、Ⅳ期的患者血清HE4、VEGF、CYFRA21-1的水平显著高于Ⅰ、Ⅱ期的患者(P<0.05);有淋巴结转移的患者血清HE4、VEGF、CYFRA21-1水平显著高于无淋巴结转移的患者(P<0.05)。血清中3种标志物的水平与患者年龄、性别、肿瘤T分期无显著相关性(P＞0.05)。血清HE4、VEGF水平与肺癌病理类型无关,而鳞状细胞癌患者血清CYFRA21-1的水平显著高于腺癌患者(P<0.05)。经受试者工作特征曲线(ROC曲线)分析显示,血清HE4、VEGF、CYFRA21-1单项检测的曲线下面积(AUC)分别为0.803、0.857和0.751,而联合检测的AUC为0.895,高于单项检测。血清HE4、VEGF、CYFRA21-1检测对肺癌诊断的灵敏度为71.7%、77.4%、73.3%,特异度为80.8%、84.2%、75.8%。三者联合检测提高了肺癌诊断灵敏度,为91.7%,但特异度有所下降,为80.3%。结论 血清中HE4、VEGF、CYFRA21-1水平在NSCLC患者中显著升高,与多项临床病理参数密切相关,且这种新的联合检测可提高NSCLC的诊断效率,有利于NSCLC的早期发现。

       

      Abstract: Objective To investigate the diagnostic value of serum tumor markers levels HE4, VEGF and CYFRA21-1 in non-small cell lung cancer (NSCLC) and its correlation with the clinicopathological features of NSCLC. Methods The levels of serum HE4, VEGF and CYFRA21-1 were measured by enzyme-linked immunosorbent assay (ELISA) using samples from 60 primary NSCLC patients, 55 patients with benign lung diseases or pneumonia and 55 healthy subjects. Results The NSCLC group produced remarkable higher levels of serum HE4, VEGF and CYFRA21-1 than the benign and healthy control groups (P<0.05). The levels of serum HE4, VEGF and CYFRA21-1 were significantly higher in patients on stages Ⅲ and Ⅳ than those on stages Ⅰ and Ⅱ (P<0.05). The levels of serum HE4, VEGF and CYFRA21-1 increased in patients with lymph node metastasis, compared with those without lymph node metastasis (P<0.05). There was no significant relationship between the serum levels of the three tumor markers and patients' age, sex and tumor T stage (P>0.05). The levels of serum HE4 and VEGF were not related with the pathological type of lung cancer, while the level of serum CYFRA21-1 was significantly higher in squamous cell carcinoma patients than those with adenocarcinoma (P<0.05). According to ROC curve, the AUC of serum HE4, VEGF and CYFRA21-1 was 0.803, 0.857 and 0.751, respectively, which was higher than the AUC of 0.895 for the combination of the three markers. The sensitivity of serum HE4, VEGF and CYFRA21-1 was 71.7%, 77.4%and 73.3%, respectively. The specificity of serum HE4, VEGF and CYFRA21-1 was 80.8%, 84.2% and 75.8%, respectively. The diagnostic sensitivity of a combination of HE4, VEGF and CYFRA21-1 increased to 91.7%, while the specificity of the combined use decreased to 80.3%. Conclusions The levels of serum HE4, VEGF and CYFRA21-1 significantly increase in NSCLC patients, which are closely related to a number of clinicopathological parameters. The new combined detection can improve the diagnostic efficiency and contribute to the early detection of NSCLC.

       

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