血清肿瘤标志物在肺癌辅助诊断中的应用

Serum Tumor Markers for Lung Cancer Diagnosis

背景与目的近年来，肺癌肿瘤标志物的研究不断取得进展，并逐步应用到临床上，本研究探讨6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、80例健康人和80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（CYFRA21—1）、鳞癌抗原（SCC）、p53抗体和癌抗原199（CA199）的含量。结果肺癌患者的6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，差异均有统计学意义（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）；CYFRA21-1、鳞癌抗原（SCC）在鳞癌中的水平明显高于其他类型的肺癌（P〈0．01）。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）；CYFRA21—1、鳞癌抗原（SCC）对鳞癌检测的敏感性明显高于其他类型的肺癌（P〈O．01）。6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6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标志物组合；CYFRA21—1、SCC可作为联合检测肺鳞癌的标志物组合。

Background and objective Progress has been made in research of lung cancer tumor markers in recent years, and these tumor markers have been used in clinical application. This study is to evaluate the regimens of six serum tumor markers in lung cancer diagnosis. Methods The serum levels of the six tumor markers（NSE, pro-GRP, CYFRA21-1, SCC, p53 antibody and CA199） were detected in 80 healthy adults, 170 patients with lung cancer and 80 patients with respiratory infection by ELISA. Results The levels of the six tumor markers in patients with lung cancer were remarkably higher than those in healthy adults and patients with respiratory infection（ P〈0.01 ） . The levels of the NSE, pro-GRP in patients with small cell lung cancer were significantly higher than those in other subtypes of the lung cancer （P〈0.01） , The levels of the CYFRA21-1, SCC in patients with squamous carcinoma was remarkably higher than that in other subtypes of the lung cancer （P〈0.01） . The sensitivity of the NSE, pro-GRP in diagnosing small cell lung cancer was remarkably higher than that in other subtypes of the lung cancer （P〈0.01） ; The sensitivity of the CYFRA21-1, SCC in diagnosing squamous carcinoma was remarkably higher than that in other subtypes of the lung cancer （P〈0.01） . The sensitivity of the tumor markers combinations in diagnosing lung cancer was remarkably higher than that of the single marker （P〈0.01） . Conclusion Detection of the six tumor markers is helpful for diagnosis lung cancer. Combination of NSE and pro-GRP is more economic than other combinations in diagnosing small cell lung cancer; Combined CYFRA21-1, SCC is more economic than other combinations in diagnosing squamous carcinoma.