血清CEA、Pro-GRP、CYFRA21-1及β_2-MG联合检测在肺癌诊断中的意义

Diagnostic significance of combined detection of serum CEA,Pro-GRP,CYFRA21-1 and β_2-MG of lung cancer

目的:探讨肿瘤标志物癌胚抗原(CEA)、胃泌素释放肽前体(Pro-GRP)、细胞角蛋白19(CYFRA21-1)及β2微球蛋白(β2-MG)水平的联合检测对肺癌临床诊断的价值。方法:分别采用电化学发光法、ELISA法和免疫浊度法测定115例肺癌、41例良性肺病患者和50例健康献血员的血清CEA、Pro-GRP、CYFRA21-1及β2-MG水平并作对比分析。结果:肺癌组血清CEA、Pro-GRP、CYFRA21-1及β2-MG的阳性检出率分别为53.9%、47.0%、61.7%、43.5%,明显高于良性肺病组(7.3%、2.4%、9.8%、12.2%)和健康对照组(4.0%、2.0%、6.0%、12.0%)(P<0.01);患者血清中的CEA、Pro-GRP、CYFRA21-1及β2-MG水平和阳性率随着临床分期升高而呈上升趋势,但差异无显著性(P>0.05);肺癌患者血清肿瘤标志物的阳性检出率,CEA以腺型最高(69.7%),Pro-GRP以小细胞型最高(76.9%),CYFRA21-1以鳞型最高(80.5%),β2-MG以鳞型最高(51.2%);四项联检对肺癌诊断的敏感性和准确性可提高到94.8%和90.3%。结论:血清CEA、Pro-GRP、CYFRA21-1及β2-MG水平的联合检测可提高肺癌的诊断效率,并为判断肺癌的病理类型、了解病情进展及治疗提供有力的依据。

Objective To study the value of clinical diagnosis of lung cancer using combination detection of the level of carcinoembryanic antigen（CEA）,progastri-releasing peptide（Pro-GRP）, cell keratin 19 segment（CYFRA21-1 ） and 132 microglobin（β2--MG. ） . Methods The level of CEA, Pro-GRP, CYFRA21-1 and β2- MG in serum were determined by using electric chemistry irradiance, enzyme-linked immunosorbent assay（ELISA） and immunity nephelometer respectively in 115 patients with lung cancer, 41patients with benign lung diseases（BLD） and 50 healthy controls and analyzed. Results The positive rates of CEA, Pro-GRP, CYFRA21-1 and β2- MG in lung cancer group （53.9%, 47.0%, 61.7% and 43.5% ,respectively）were remarkably higher than those in BLD group（7. 3%, 2.4%, 9. 8% and 12. 2% ,respectively） and in healthy controls group （4. 0%, 2.0%, 6.0% and 12. 0%, respectively） （ P 〈 0.01 ）. Although the sufferer of serum level and positive rates of CEA, Pro-GRP, CYFRA21-1 and β2-- MG in stage Ⅰ ＋ Ⅱ, Ⅲ and Ⅳ appeared to be associated with the clinical stages of lung cancer, there was no statistical significance among the three groups（ P 〉 0.05） . The results showed that CEA, Pro-GRP, CYFRA21-1 and β2-- MG were relatively specific for adenoeareinomas（69. 7% ）, small-ceil lung cancer（76.9% ）, squamous ceil carcinoma （80. 5% ）and squamous ceil carcinoma（51.2% ）, respectively;the accuracy and sensitivity of the combined detection group of four tumor markers were 94. 8% and 90. 3%. Conclusion The combined measurement of serum CEA, Pro-GRP, CYFRA21-1 and β2--MG can increase positive rate of lung cancer, also orovide potent diagnosis basis for judging pathologic type, understanding state of an illness and treatment.