肿瘤标记物联合检测在肺癌诊断中的应用价值

Evaluation of Clinical Validity of Combination Measurement of Tumor Markers in Diagnosis of Lung Cancer

目的探讨联合检测血清肿瘤标记物CEA、NSE、CYFRA21-1、TPA、CA15-3、CA242在肺癌临床诊断中的价值。方法应用放射免疫法和酶联免疫法检测108例肺癌病人、40例肺良性病变病人及41例正常健康人的血清中CEA、NSE、CYFRA21-1、TPA、CA15-3、CA242的水平。结果肺癌组血清6项肿瘤标记物含量均高于肺良性病变组及正常组;CEA、CA15-3、CA242在肺腺癌中的水平最高,NSE在肺小细胞癌中的水平最高,CYFRA21-1、TPA在肺鳞癌中的水平最高,6项联合检测肺鳞癌、肺腺癌、肺小细胞癌的阳性率可分别达97.5%、100%、95.8%。结论运用联合检测多种肿瘤标记物可以提高肺癌诊断的敏感性,同时对于确定其临床分期和鉴别病理类型具有一定的意义。

Objective To study the clinical validity of combined measurement of tumor markers in diagnostic evaluation of lung cancer. Methods Serum levels of CEA, NSE, CYFRA21 -1, TPA, CA15 - 3 and CA242 were measured by radioimmunoassay and ELISA in 108 patients with lung cancer, 40 patients with benign pulmonary diseases and 41 healthy subjects and analyzed. Results The levels of CEA,NSE, CYFRA21 - 1, TPA, CA15 3 and CA242 in lung cancer patients were significantly higher than that in patients with benign pulmonary diseases and healthy subjects. The patients with pulmonary adenocarcinoma had the highest CEA, CA15 3 and CA242 levels, patients with small cell lung carcinoma had the highest NSE level, while patients with lung squamous cell carcinoma had the highest CYFRA21 - 1 and TPA levels. The positive rate of the combined measurement of CEA, NSE, CYFRA21 - 1, TPA, CA15 - 3 and CA242 for lung squamous cell carcinoma, adenocarcinoma and small cell carcinoma were 97.5%, 100% and 95.8% respectively. Conclusion Combined measurement of multiple serum tumor markers significantly increases the diagnosis sensitivity. In addition, it is also of significance in defining cancer clinical staging and identification of pathologic category.