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目的:探讨细胞角蛋白19-2G2(CK19-2G2)与血清学检测其它指标在肺癌诊断中的临床应用。方法:用化学发光免疫分析法测定71例肺癌患者血清CK19-2G2,并同步检测临床肿瘤诊断常用的血清学指标CEA、NSE、Cyfra21-1,与52例肺部良性疾病和40例健康体检者进行对照比较,计算单项或联合检测的敏感性和特异性,绘制KOC曲线,计算KOC曲线下面积。结果:单指标检测,CK19-2G2对肺癌的诊断敏感性为69.01%,特异性为95.56%,高于CEA、NSE、Cyfra21-1;CK19-2G2的ROC曲线下面积最大(0.783,95%可信区间0.699～0.868),临床诊断效能高于CEA、NSE、Cyfra21-1;多指标联合检测,敏感性可提高至84.51%,且敏感性和特异性之和最大。结论:CK19-2G2为一高度敏感的肺癌诊断血清学标志物,其与CEA、NSE、Cyfra21-1联合检测,对于早期筛查和辅助诊断肺癌有重要意义。
Objective: To investigate the clinical application of cytokeratin 19-2G2 (CK19-2G2) and other serological markers in the diagnosis of lung cancer. Methods: Chemiluminescent immunoassay was used to detect CK19-2G2 in serum of 71 patients with lung cancer. Serum CEA, NSE, Cyfra21-1, commonly used in the diagnosis of clinical tumor, were simultaneously detected with 52 benign pulmonary diseases and 40 healthy subjects For comparison, calculate the sensitivity and specificity of single or combined detection, draw the KOC curve and calculate the area under the curve of KOC. Results: The sensitivity and specificity of CK19-2G2 for lung cancer were 69.01% and 95.56%, respectively, which were higher than those of CEA, NSE and Cyfra21-1. The area under the ROC curve of CK19-2G2 was the highest (0.783 and 95% Confidence interval of 0.699 ~ 0.868). The clinical diagnostic efficiency was higher than that of CEA, NSE and Cyfra21-1. The combined detection of multiple indexes could increase the sensitivity to 84.51% and the sensitivity and specificity were the highest. Conclusion: CK19-2G2 is a highly sensitive diagnostic serological marker for lung cancer. Combined with CEA, NSE and Cyfra21-1, CK19-2G2 is of great significance for early screening and diagnosis of lung cancer.