10种血清肿瘤标志物在肺癌诊断中的临床评价

Clinical evaluation of ten tumor markers for diagnosis of lung cancer

目的:探讨10种肿瘤标志物对肺癌诊断临床价值。方法:临床确诊的肺癌患者40例为肺癌组,非肿瘤患者30例为对照组。用化学发光法检测癌胚抗原(CEA)、糖类抗原199(CA-199)、糖类抗原125(CA-125)、糖类抗原153(CA-153)等10种血清肿瘤标志物,临床评价血清肿瘤标志物不同组合的灵敏度、特异性、准确度、阳性预测值、阴性预测值。结果:肺癌组血清CEA、CA-199、CA-125和CA-153检测水平值均明显高于对照组(P<0.01)。CEA有高灵敏度和准确度(95%和87.14%),CEA和CA-199有高特异性(76.67%)。肿瘤标志物两两联合或三项联合,对肺癌诊断的灵敏度、准确度、特异性均有明显提高(P<0.001)。结论:CEA等肿瘤标志物检测水平值对肺癌的诊断有临床应用价值,联合检测可适度提高诊断的灵敏度和准确度。

Objective ：To Study on the clinical significance of ten tumor markers （ CEA, AFP, CA - 153, etc. ） in the diagnosis of lung cancer. Methods：Forty patients with lung cancer （lung cancer group） and thirty patients with no lung cancer and healthy people （control group） were＇studied. Serum CEA, AFP, CA- 199, CA- 125, CA- 153, β- HCG, PSA- total, PSA -free, Fcrr and β2 - M were measured with CMIA. The sensitivities, specificities, accuracies, positive predictive values and negative predictive values of different combinations of those tumor markers for the diagnosis of lung cancers were evaluated. Results： The levels of CEA, CA199, CA - 125 and CA - 153 in lung cancer group were higher than in control group （ P 〈 0. 01 ）. CEA had the highest sensitivity and accuracy （95% and 87. 14% ）, CEA and CA - 199 had the highest specificity （76. 67% ）. The combinations with several tumor markers had higher sensitivities, specificities, accuracies than the single marker for the diagnosis of lung cancer （P 〈 0. 001 ）. Conclusion：These tumor marker levels （CEA, CA - 199, CA - 125 and CA - 153 ） are helpful for the diagnosis of lung cancer. The sensitivity and accuracy can be improved with combination of some tumor markers.