血清肿瘤标志物在肺癌辅助诊断中的应用

The value of serum tumor marker in the diagnosis of lung cancer

目的探讨5种血清肿瘤标志物在肺癌辅助诊断中的应用价值,并选择最理想的血清肿瘤标志物组合。方法应用酶联免疫吸附实验(ELISA)检测170例肺癌患者、50例健康人和60例肺部良性疾病患者血清中神经元特异性烯醇化酶(NSE)、胃泌素释放肽前体(pro GRP)、细胞角蛋白19(CYFRA211)、p53抗体和癌胚抗原(CEA)的水平含量。结果肺癌患者的5种血清肿瘤标志物水平均明显高于健康人组和肺部良性疾病组,差异有统计学意义(P<0.01)。NSE、pro GRP在小细胞肺癌中的水平明显高于其他类型的肺癌(P<0.01),CYFRA211在鳞癌中的水平明显高于其他类型的肺癌(P<0.01)。p53抗体的特异性为100%,NSE、pro GRP对小细胞肺癌检测的敏感性明显高于其他类型的肺癌(P<0.01),CYFRA211对鳞癌检测的敏感性明显高于其他类型的肺癌(P<0.01)。5种血清肿瘤标志物经组合后,敏感性明显高于任一单项肿瘤标志物(P<0.01)。结论5种血清肿瘤标志物对于肺癌的辅助诊断有一定的临床意义。NSE、pro GRP二者可作为联合检测小细胞肺癌的首选标志物,CYFRA211、CEA和p53抗体三者可作为联合检测非小细胞肺癌的首选标志物。p53抗体对肺癌的辅助诊断有很高的特异性,CYFRA211对鳞癌的辅助诊断有一定的作用。

Objective To evaluate five serum tumor markers used alone or in combination for the diagnosis of lung cancer. Methods The level of five serum tumor markers: NSE?pro-GRP?CYFRA21-1?p53 antibody and CEA was detected by ELISA in 50 healthy adults,170 lung cancer patients and 60 patients with respiratory infection. Results The level of the five serum tumor markers in lung cancer patients was significantly higher than that of healthy adults and patients with respiratory infection(P<0.01).The level of NSE and pro-GRP in patients with small-cell lung cancer was significantly higher than those of the other subtypes of lung cancer(P<0.01); The level of CYFRA21-1 in patients with squamous-cell carcinoma was significantly higher than that of other subtypes(P<0.01).The specificity of p53 antibody was 100% in diagnosing lung cancer and the sensitivity of NSE,pro-GRP was much higher for small-cell lung cancer than for other subtypes(P<0.01); The same was observed in CYFRA21-1 for the diagnosis of squamous-cell carcinoma(P<0.01).The sensitivity of the tumor markers in diagnosing lung cancer was significantly enhanced if used in combination (P<0.01). ConclusionThese five tumor markers are valuable auxiliary parameters in diagnosing lung cancer. The combination of NSE and pro-GRP is more appropriate than other combinations in diagnosing small-cell lung cancer;the combination of CYFRA21-1?CEA and p53 antibody is the most valuable combination for diagnosing non-small-cell lung cancer. p53 antibody has the highest specificity for diagnosing lung cancer;CYFRA21-1 is the most valuable parameter for diagnosing squamous carcinoma.