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目的探讨血清胸苷激酶-1(TK1)与癌胚抗原(CEA)、细胞白蛋白19片段(CYFRA21-1)、神经元特异性烯醇化酶(NSE)、鳞状上皮细胞癌抗原(SCC)联合检测在肺癌诊断中的意义。方法本研究选取2012-2014年在深圳市人民医院做健康体检和门诊病人的2 500例健康体检者做为研究对象,检测其血清TK1、CEA、CYFRA21-1、NSE、SCC,将最后依据影像学检查或病理活检检测出肺癌、肺部良性病变和健康者分为三组,分别比较三组人群血清TK1、CEA、CYFRA21-1、NSE和SCC的表达情况差别。结果肺癌患者血清中五种血清肿瘤标志物阳性率均明显高于良性对照组、正常对照组(均P<0.05)。且肺癌组患者血清TK1与CEA、CYFRA21-1、NSE、SCC含量明显高于良性对照组和健康对照组,差异均有统计学意义(均P<0.05)。在单项检测中,TK1的敏感度、特异度、准确度、阳性预测值和阴性预测值为最高,但其灵敏度仅为47.9%。血清中五项指标并联试验联合检测其敏感度明显提高为85.4%,但特异度有所下降,仍有75.9%。结论研究结果显示,血清TK1可作为鉴别肺部良恶性病变的早期检验指标之一,联合CEA、CYFRA21-1、NSE、SCC等指标检测能为健康体检中肺癌的早期筛查提供较高的临床参考价值。
Objective To investigate serum thymidine kinase-1 (TK1) and carcinoembryonic antigen (CEA), cell albumin 19 fragment (CYFRA21-1), neuron specific enolase (NSE), squamous cell carcinoma antigen (SCC) The significance of combined detection in the diagnosis of lung cancer. Methods In this study, 2 500 health checkups from Shenzhen People’s Hospital during 2012-2014 were selected as subjects and their serum TK1, CEA, CYFRA21-1, NSE and SCC were detected. Lung cancer, lung benign lesions, and healthy subjects were classified into three groups by examination or pathological biopsy. The differences in the expression of serum TK1, CEA, CYFRA21-1, NSE, and SCC were compared between the three groups. Results The positive rates of five serum tumor markers in lung cancer patients were significantly higher than those in the benign control group and the normal control group (all P<0.05). The levels of serum TK1 and CEA, CYFRA21-1, NSE and SCC in lung cancer patients were significantly higher than those in benign controls and healthy controls, with statistically significant differences (all P<0.05). In a single test, TK1 had the highest sensitivity, specificity, accuracy, positive predictive value, and negative predictive value, but its sensitivity was only 47.9%. The sensitivity of the five indicators in the serum combined test was significantly increased to 85.4%, but the specificity was reduced, still 75.9%. Conclusion The results of the study show that serum TK1 can be used as one of the early detection indicators for distinguishing benign and malignant lung diseases. Combined detection of CEA, CYFRA21-1, NSE, SCC and other indicators can provide high clinical value for early screening of lung cancer in physical examinations. Reference value.