血液HSP90α、CEA、NSE、CYFRA21-1及SCCA联合检测对肺癌的诊断价值研究

Value of blood HSP90α, CEA, NSE, CYFRA21-1 and SCCA in diagnosis of lung cancer

摘要:

评价血液热休克蛋白90α（HSP90α）、癌胚抗原（CEA）、神经元特异性烯醇化酶（NSE）、细胞角蛋白19 片段（CYFRA21-1）及鳞状细胞癌抗原（SCCA）在肺癌（LC）中的诊断价值。方法将LC 患者分为鳞癌（LAC）、腺癌（LSC）及小细胞癌（SCLC）3 组，比较各组标志物。结果SCLC 组HSP90α、CEA、NSE 及CYFRA21-1 较对照组增高，HSP90α高于LAC 组和LSC 组；LAC 组HSP90α、NSE、CYFRA21-1 及SCCA较对照组增高，SCCA 高于SCLC 组和LSC 组；LSC 组HSP90α和CEA 较对照组增高；HSP90α的受试者工 作特征曲线下面积最大。串联分析HSP90α+NSE+CYFRA21-1可提高SCLC 的特异性、阳性预测值及正确分类率，HSP90α+NSE+CYFRA21-1+SCCA 和HSP90α+CEA 可分别提高LAC、LSC 的特异性和阳性预测值，正确分类率为理想水平。结论HSP90 是筛查LC 的理想指标；联合检测HSP90α 等5 种标志物有助于LC 的分层诊断。

Abstract:

To evaluate the value of HSP90α, carcinoembryonic antigen (CEA), neuron-specificenolase (NSE), cytokeratin 19 (CYFRA21-1) and squamous cell carcinoma antigen (SCCA) in the diagnosis of lung cancer (LC). Methods Patients who were diagnosed as LC were divided into squamous cell carcinoma (LAC) group, adenocarcinoma (LSC) group and small cell carcinoma (SCLC) group. The concentrations of HSP90α, NSE, CEA, CYFRA21-1 and SCCA in blood were analyzed and compared among the 3 groups. Results The levels of HSP90α, CEA, NSE and CYFRA21-1 in the SCLC group were significantly higher than those in the control group ( p< 0.05). The HSP90αlevel in the SCLC group was higher than that in the LAC and LSC groups ( p< 0.05). The levels of HSP90α, NSE, CYFRA21-1 and SCCA in the LAC group were significantly higher than those in the control group ( p< 0.05). The SCCA level of the LAC group was significantly higher than that of the SCLC and LSC groups ( p< 0.05). The levels of HSP90α and CEA in the LSC group were significantly higher than that in the control group (p <0.05). The AUC of HSP90α was the highest. The combined detection of HSP90α, NSE and CYFRA21-1 could significantly improve the specificity (SPE), positive predic-tive value (PV+), positive likelihood ratio (LR+) and correct classification rate (CCR) in the diagnosis of SCLC.The combined detection of HSP90α, NSE, CYFRA21-1 and SCCA could significantly improve the SPE, PV+and CCR of LAC, while the combined detection of HSP90αand CEA could significantly improve the SPE,PV+, LR+ and CCR of LSC. Conclusions HSP90 is an ideal index for diagnosis of LC. Combined detectionof HSP90α, CEA, NSE, CYFRA21-1 and SCCA contribute to the stratification of lung cancer.