肿瘤标志物联合检测晚期肺癌的临床意义

The significance of combined assays of serum tumor marker in advanced lung cancer

目的:探讨肿瘤相关物质(TSGF)、癌胚抗原(CEA)、癌抗原125(CA125)、细胞角蛋白19(CY21- 1)联合检测在晚期肺癌诊断中的临床意义。方法:采集85例有肺部疾病的患者血清,用化学发光法检测其血清TSGF、CEA、CA125、CY21- 1 的含量。结果:肺癌患者血清TSGF、CEA、CA125、CY21 -1 的阳性率分别为73. 24%、83.09%、53.52%和61.97%,均明显高于肺部良性病变组(P<0.01)。4种肿瘤标记物单项在晚期肺癌中的灵敏度、特异度的差异无统计学意义(P>0.05)。血清CEA和CY21 1联合检测鳞癌的阳性率为76%,与腺癌阳性率(83.78%)的差异无统计学意义(P > 0. 05)。CEA 联合CA125 检测腺癌的阳性率为94. 59%,高于鳞癌的84.00%及肿瘤标志物单项对腺癌的阳性检出率(P < 0. 05)。结论:血清肿瘤标志物TSGF、CEA、CA125 和CY21 -1联合检测可提高肺癌的诊断阳性率,建议联合检测方式为CEA+CA125。

Objective: To study the clinical significance of tumor marker with combined assaying in the diagnosis. Methods: Serum samples were collected from 85 in-patients. The concentrations of serum TSGF, CEA, CA125 and CY21-1 were determined by chemiluminescence. Results:In lung cancer group, the total positive rates of TSGF, CEA, CA125 and CY21-1 are 73.24%,83.09%,53,52%,61.97% respectively, which were significantly higher than that in benign lung disease group(P<0.01). There was no significant difference of serum single tumor marker sensitivity and specificity in advanced lung cancer(P> 0.05). The sensitivity of combined assay with serum CEA+CY21-1 in diagnosing squamous cell carcinoma was 76%, adenocarcinoma was 83.78%. No significant difference of serum CEA+CY21-1 sensitivity between squamous cell carcinoma and adenocarcinoma(P>0.05).The sensitivity of combined assay with serum CEA+CA125 in diagnosing adenocarcinoma was 94.59%,which was significantly higher than that in squamous cell carcinoma (84%) and the sensitivity of single tumor marker in adenocarcinoma(P<0.05). Conclusion: The sensitivity in diagnosis lung cancer is raised by combined assaying with TSGF, CEA, CA125 and CY21-1. It is suggested that combined assay with CEA+CA125 would be better.