海军医学杂志

目的 探讨异常糖链糖蛋白（TAP）联合血清肿瘤标志物对非小细胞肺癌（NSCLC）的早期诊断价值。方法 回顾性分析南通市中医院2019年1月至2021年10月收治的80例NSCLC患者的病历资料，为NSCLC组，均以病理学检查为金标准，另选取该院同期80例肺部良性病变患者的病历资料进行对照，为良性病变组。收集并整理所有受试者的临床资料，分析血清肿瘤标志物[神经元特异性烯醇化酶（NSE）、细胞角蛋白19片段（CYFRA21-1）、癌胚抗原（CEA）、糖类抗原125(CA125)]和TAP水平。采用Logistic多因素回归分析探究NSCLC发病的影响因素，受试者操作特征（ROC）曲线判定2组患者血清肿瘤标志物及TAP对不同分期NSCLC的诊断效能。结果 NSCLC组患者TAP、NSE、CYFRA21-1、CEA、CA125水平均高于良性病变组（P<0.05）。NSCLC组患者吸烟史及从事高油烟或高密度粉尘等相关工作职业所占比例均高于良性病变组（P<0.05）。Logistic多因素回归分析结果显示，吸烟史、从事高油烟或高密度粉尘等相关工作职业及血液TAP、NSE、CYFRA21-1、CEA、CA125水平升高均为NSCLC发病的影响因素（P<0.05）。ROC分析显示，TAP、NSE、CYFRA21-1、CEA、CA125单一诊断Ⅰ～Ⅳ期NSCLC患者的灵敏度中TAP、NSE诊断效能较高。TAP联合NSE诊断Ⅰ～Ⅳ期NSCLC患者的AUC分别为0.642、0.679、0.774、0.791,4项血清肿瘤标志物和TAP联合诊断Ⅰ～Ⅳ期NSCLC患者的曲线下面积（AUC）分别为0.649、0.683、0.785、0.794。结论 TAP联合NSE诊断Ⅰ～Ⅳ期NSCLC的诊断效能较高，具有广阔的临床应用前景。

Objective To investigate the early diagnosis value of tumor abnormal protein(TAP) combined with serum tumor markers in early diagnosis of non-small cell lung cancer(NSCLC).Methods The medical records of 80 patients with NSCLC admitted to the hospital from January 2019 to October 2021 were analyzed retrospectively,with the pathological examination as the gold standards.The medical records of another 80 patients with benign lung lesions within the same time span were selected for control.The clinical data of all the subjects were collected and sorted out,and the expression levels of serum tumor markers,including neuron specific enolase(NSE) and cytokeratin 19 fragment(CYFRA21-1),carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125) and TAP were detected and analyzed.Logistic multivariate regression analysis was used to analyze the influencing factors of NSCLC,and the working characteristic curve(ROC) of the subjects was used to determine the diagnostic efficacy of serum tumor markers and TAP at different stages of NSCLC.Results The levels of TAP,NSE,CYFRA21-1,CEA and CA125 in the NSCLC group were all higher than those in the benign group(P<0.05).The proportions of those with a smoking history and such related occupations as high-oil-smoke or high-density dust in the NSCLC group were all higher than those in the benign group(P<0.05).Logistic multivariate regression analysis showed that those with a smoking history,occupations with high-oil-smoke or high-density dust,and increased expression levels of TAP,NSE,CEA,CA125 and CYFRA21-1 were all influential factors for the onset of NSCLC(P<0.05).ROC analysis showed that the indexes of TAP,NSE,CYFRA21-1,CEA and CA125 displayed relatively higher diagnostic efficiency in single diagnosis of stage I-IV NSCLC in terms of sensitivity.The AUCs of TAP combined with NSE in the diagnosis of stage I-IV NSCLC were 0.642,0.679,0.774 and 0.791 respectively,and the AUCs of the five indexes in combined diagnosis of NSCLC were 0.649,0.683,0.785 and 0.794 respectively.Conclusion TAP combined with NSE displays high efficiency in the diagnosis of stage I-IV NSCLC,therefore it promises a good future for clinical application.