联合检测癌性与结核性标志群对肺结核、肺炎、肺癌患者的临床意义评价

To Evaluat the Clinical Meaning of Checked the Malignat Marker Combination With Tuberculo-marker on Pulmonary Tuberculosis,Lung Cancer and Pneumonia

目的 寻求适用于肺结核、肺癌、肺炎的早期诊断最佳标志群组。方法 酶联免疫吸附法联合检测294例肺病患者血清中癌胚抗原(CEA)、神经元烯醇化酶(NSE)、转铁蛋白(Tf)的含量及结核抗体(TB-CHECK-1)的定性。结果 肺癌组血清CEA、NSE、Tf的含量分别为16.7±18.7μg/L、158±42.7μg/L、52.6±68.1μg/L,均高于结核组及肺炎组,P<0.001;肺结核组血TB-CHECK-1的阳性率为79.4％,高于肺癌组及肺炎组,P<0.001。CEA对肺腺癌、NSE对肺小细胞癌、Tf对肺鳞癌有较高的敏感性及特异性。以CEA+NSE+Tf为组合(任一单项阳性即为组合阳性、三项均阴性即组合阴性),结合TB-CHECK-1检测结果,对肺癌、肺结核及肺炎进行判断,其敏感性分别为90.5％、70.2％、81.0％,特异性分别为90.0％、97.5％、93.0％。结论 联合检测肺病组血清中CEA、NSE、Tf,并结合TB-CHECK-1定性对肺部疾病的鉴别和早期诊断有重要价值。

Objective To search joint examination of the best biomarkers improved the early diagnosis of pulmonary tuberculosis, lung cancer and pneumonia. Methods 294 cases of the pulmonary disease were joint examined the level of CEA, NSE,Tf in the serum and the positive (or negative )rate of TB-CHECK-1 in the blood by enzyme-linked immunosorbent assay (ELISA). Results The level of CEA,NSE,Tf of the lung cancer was 16. 7?8. 6μg/L,158. 0?2. 71μg/L,52. 6?8. 1μg/ L,respectively,they were more than the pulmonary tuberculosis and pneumonia(P<0. 001). The positive rate of TB-CHECK-1 in the pulmonary tuberculosis was 79. 4% rit was more than lung cancer and pneumonia(P<0. 001). CEA vs lung adrenocar-cinoma,NSE vs small lung cell cancer,Tf vs lung squama carcinoma had the high sensitivity and speciality. Made the CEA+ NSE+Tf a combination. (If evry of the CEA+NSE+Tf was positive,that the combination was positive. If all of the CEA+ NSE+Tf was negative,that the combination was negative). Examined the CEA+NSE+Tf combine with the TB-CHECK-1 to differentiat the lung cancer,pulmonary tuberculosis and pneumonia. The sensitivity were 90. 5%,97. 5%,93. 0% respectively, and speciality were 90. 0% ,97. 5% ,93. 0% ,respectively. Conclusion To examine the pulmonary disease with the CEA + NSE+Tf combine with TB-CHECK-1 is more important value on improve the early diagnosis of pulmonary disease and differentiat the pulmonary disease who unable to acquire pathogen and pathology.