血清细胞角蛋白19、神经元特异性烯醇化酶及鳞状上皮细胞癌抗原在小细胞肺癌诊断及病情评估中的作用研究

摘要 目的：分析血清细胞角蛋白19（CK19）、神经元特异性烯醇化酶（NSE）及鳞状上皮细胞癌抗原（SCCA）在小细胞肺癌诊断及病情评估中的作用。方法：选择我院自2020年1月至2022年7月收治的85例小细胞肺癌患者作为观察组，另选同期的85例肺部良性疾病患者作为对照组。检测两组血清CK19、NSE、SCCA表达水平，比较两组血清CK19、NSE、SCCA表达水平及其阳性率，使用ROC曲线下面积（AUC）分析上述指标对小细胞肺癌的诊断效能，观察小细胞肺癌不同分期患者血清CK19、NSE、SCCA表达水平的差异性，分析观察组治疗前后血清CK19、NSE、SCCA表达水平的变化情况。结果：观察组血清CK19、NSE、SCCA表达水平均较对照组高（P＜0.05）；观察组血清CK19、NSE和SCCA的阳性率均较对照组高（P＜0.05）；经ROC曲线分析，血清CK19、NSE联合SCCA诊断小细胞肺癌的敏感度为91.23 %，特异度为84.67 %，AUC为0.910；在85例小细胞肺癌患者中，临床分期为局限期33例、广泛期52例；广泛期患者血清CK19、NSE、SCCA表达水平均高于局限期患者（P＜0.05）。结论：血清CK19、NSE联合SCCA诊断小细胞肺癌的效能较好，三者均与患者病情严重程度有关，有利于此病的早期诊断和病情评估，值得进一步研究应用。

The Role of Serum Cytokeratin 19, Neuron-specific Enolase and Squamous Epithelial Cell Carcinoma Antigen in the Diagnosis and Disease Assessment of Small Cell Lung Cancer

ABSTRACT Objective: To analyze the role of serum cytokeratin 19 (CK19), neuron-specific enolase (NSE) and squamous epithelial cell carcinoma antigen (SCCA) in the diagnosis and disease assessment of small cell lung cancer. Methods: 85 patients with small cell lung cancer admitted to our hospital from January 2020 to July 2022 were selected as the observation group, and 85 patients with benign lung diseases were selected as the control group. The expression levels of CK19, NSE and SCCA in serum of the two groups were detected, and the expression levels and positive rates of CK19, NSE and SCCA in serum of the two groups were compared. The area under ROC curve (AUC) was used to analyze the diagnostic efficacy of these indicators in small cell lung cancer. To observe the differences of serum CK19, NSE and SCCA expression levels in patients with different stages of small cell lung cancer, and to analyze the changes of serum CK19, NSE and SCCA expression levels in the observation group before and after treatment. Results: The expression levels of CK19, NSE and SCCA in the observation group were higher than those in the control group(P<0.05). The positive rates of CK19, NSE and SCCA in the observation group were higher than those in the control group (P<0.05). ROC curve analysis showed that the sensitivity, specificity and AUC of serum CK19 and NSE combined with SCCA in the diagnosis of small cell lung cancer were 91.23 %, 84.67 % and 0.910. Among the 85 patients with small cell lung cancer, the clinical stage was localized in 33 cases and extensive in 52 cases. The expression levels of CK19, NSE and SCCA in patients with extensive stage were higher than those in patients with stage stage (P<0.05). Conclusion: Serum CK19 and NSE combined with SCCA have good efficacy in the diagnosis of small cell lung cancer. All three are related to the severity of patients'' disease, which is conducive to the early diagnosis and disease evaluation of this disease, and worthy of further research and application.