血清NSE、CA242、TPA、CEA联检对肺癌的诊断价值

Diagnostic Value of Combined Determination of Serum Tumor Markers (NSE,CA-242,TPA,CEA) Levels in Patients with Lung Cancer

目的:探讨血清神经元特异性烯醇化酶(NSE)、糖类抗原CA242、组织多肽抗原(TPA)、癌胚抗原(CEA)联检对肺癌的诊断价值。方法:应用酶联免疫法(ELISA)对102例肺癌、33例肺结核及30名健康人血清进行观察。结果:①四项指标在不同组织类型肺癌中均有不同程度升高且明显高于肺结核组及健康对照组。②综合评价肺癌组两项同时阳性者腺癌(AC)为75%、鳞癌(Sq)50%及小细胞肺癌(SCLC)65%,而结核组假阳性率仅为9%,健康组未发现假阳性者。③NSE诊断SCLC的敏感性为72%,特异性为97%;CA242诊断AC的敏感性为62%、Sq39%及SCLC为31%,特异性为90%。结论:四项指标对不同组织类型肺癌均有一定诊断价值,联合测定时可以提高对肺癌的阳性诊断。

Objective To investigate the diagnostic value of combined determination of serum NSE, CA242, tissue polypepfide antigen （TPA） and CEA levels in patients with primary lung cancer. Methods Serum NSE, CA242, TPA and CEA levels were determined with ELISA in （1） 102 patients with various types of primary lung carcinoma （ adenocarcinoma 38, squamous cell carcinoma 32, areall cell lung carcinoma 32） （2） 33 patients with open lung T. B. and （3） 30 controls. Results （1） In patients with lung cancer, serum levels of all the four markers were increased and significantly higher than their respective values in patients with open lung T. B. and cuntrols.（2） Positive rate of combined any two markers were 75% for adenocarcinoma, 50% for squamous cell carcinoma and 65% for areall cell lung carcinoma, while false positive rate was only 9% for T. B patients and none for the controls. （3） The most appropriate single marker for each specific type of lung cancer was ： NSE for SCLC （ sensitivity 72% , specificity 97%, CA242 for adenocarcinoma sensitivity 62%, specificity 90% ）. Conclusion Combined determination of these tumor markers would improve the sensitivity and specificity for diagnosis of primary lung carcinoma.