血清肿瘤标志物联合检测在肺癌诊断中的临床应用

Cliniacal Application of Combined Measurement of Serum Tumor Markers in Diagnosis of Lung Cancer

目的探讨血清中糖类抗原125(CA125),糖类抗原153(CA153),糖类抗原199(CA199),癌胚抗原(CEA),神经元特异性烯醇化酶(NSE),细胞角蛋白片断21(CYFRA21-1)等6项肿瘤标志物(TM),单项和联合检测在肺癌早期诊断中的价值。方法采用电化学发光免疫分析法,试剂盒由美国罗氏公司提供,肺癌组病例184例均经细胞学或组织病理学确认的初诊病例,对照组为同期住院的呼吸道炎症性疾病(RIDS)病例,肺癌组病例检测6项TM。结果肺癌组6项TM水平和阳性率显著高于RIDS病例,差异有统计学意义(P<0.01)。单项TM检测肺癌的特异性均较高,达96.8%～98.9%,但敏感性较低,在23.4%～53.3%,TM联合检测可显著提高诊断率,5项组合阳性率可达82.1%(P<0.01)。结论TM的联合检测,可提高肺癌的的早期发现率,为肺癌的诊断、分型提供可靠的依据,有重要的临床应用价值。

[ Objective] To investigate the value of combination or single detection of serum CA125, CA199, CA153, CEA, NSE and CYFRA21-1 in early diagnosis of lung cancer. [ Methods] The serum levels of these tumor markers were measured by Electrochemil immunoassay [ECLIA）. The kits were provided by Roche U.S. 184 newly diagnostic patients with lung cancer in lung cancer group were identified by cytology or histopathology, controls were synchronous patients in hospital with Respiratory Inflammatory Diseases （RIDS）. 6 TM were measures in lung cancer group. [ Results ] The level and positive rate for 6 TM in patients with lung cancer were significantly higher than that of RIDS patients （ P 〈0. 01 ）. The specificity for lung cancer of single detection of TM was high ,up to 96.8% -98.9%, however, the sensitivity of that was only 23.4% - 53.3%. combination detection of TM can increase diagnostic rate, positive rate for combination detection of 5 TM was up to 83. 1% （ P 〈 0.0 1 ）. [ Conclusion] Combination detection of serum TM can improve the early detection rate, and provide reliable evidence for diagnosis and type classification of pathology, and is of important value in clinical application.