胸水和血清中CEA、CYFRA21-1、TPS联合检测对良恶性胸水及肺癌的诊断价值

Clinical value of combined determination of serum and pleural effusion level of CEA,CYFRA21-1,TPS in the diagnosis of lung cancer

目的:探讨胸水和血清肿瘤标志物癌胚抗原(CEA),细胞角蛋白片段21-1(CYFRA21-1),组织多肽特异性抗原(TPS)在肺癌诊断中的临床意义。方法:应用电化学发光法和ELISA分别测定78例肺癌患者,45例肺部良性疾病胸水和血清CEA、CYFRA21-1、TPS水平,结果:肺癌组胸水CEA、CYFRA21-1、TPS水平明显高于良性疾病胸水组(P<0.01);肺癌组血清CEA、TPS水平明显高于良性疾病血清组(P<0.05,P<0.01);在不同病理类型肺癌中3种肺癌肿瘤标志物升高的程度均有所不同;恶性胸水组中肿瘤标志物的含量与同期血清中的含量相比,出现更早且浓度更高,尤以TPS升高最为明显。单项检测中,胸水TPS的敏感性最高,联合检测中,胸水TPS+CYFRA21-1+CEA的敏感性和准确性最高。结论:CEA、CYFRA21-1、TPS三项联合检测对良恶性胸水的鉴别有较好的诊断价值。胸水中3种肺癌标志物的联合检测较血清有更高的敏感性,准确性。其临床价值优于血清。

AIM： To study the clinical value of combined determination of carcinoembryonic antigen （CEA）, cytokeratin-19-fragments（ CYFRA21-1 ） and tissue polypeptide specific antigen（TPS） levels in both serum and pleural effusion in the diagnosis of lung cancer. METHODS： The levels of CEA, CYFRA21-1 and TPS in serum and pleural effusion were measured in 78 patients with lung cancer and 45 patients with benign lung disease by using electrochemiluminescence and ELISA methods respectively. RESULTS. The levels of CEA, CYFRA21-1 and TPS in pleural effusion of patients with lung cancer were much higher than those with benign lung disease （ P 〈 0.01 ）. The levels of CEA and TPS in serum of patients with lung cancer were much higher than those with benign lung disease （ P 〈 0, 05, P 〈 0, 01 ）, It was also found that the levels of these tumor markers in pleural effusion were higher and more sensitive than those in sera, especially TPS, TPS showed the highest sensitivity in single tumor marker detection, and TPS ＋ CYFRA21-1 ＋ CEA showed the highest sensitivity and accuracy in com- bined tumor marker detection for diagnosis of lung cancer in pleural effusion, CONCLUSION： The combined detection of CEA, CYFRA21-1and TPS in pleural effusion showed higher sensitivity, better accuracy and higher clinical value than those in serum for diagnosis of lung cancer.