支气管肺泡灌洗液肿瘤标志物联合检测诊断肺癌的研究

DIAGNOSIS OF LUNG CANCER BY COMBINED TUMOR MARKERS IN BLONCHOALVEOLAR LAVAGE FLUIDS

探讨支气管肺泡灌洗液中的成分对肺癌的诊断价值。方法：应用纤维支气管镜行支气管肺泡灌洗，收集其灌洗液检测 Ｃ Ｅ Ａ 、β２ － Ｍ Ｇ，并选择钾离子（ Ｋ＋ ） 作校正后进行统计学处理分析。结果：肺癌组 Ｂ Ａ Ｌ Ｆ 测得 Ｃ Ｅ Ａ／ Ｋ＋ 与β２ － Ｍ Ｇ／ Ｋ＋ 数值经统计学处理均分别较良性肺病组增高，两组阳性率比较均具有显著意义，若同时测定 Ｃ Ｅ Ａ／ Ｋ＋ 、β２ － Ｍ Ｇ／ Ｋ＋ 加上癌细胞学三项联合检测，就有９３ ．７５ ％ 的癌症患者至少有一项或以上的指标阳性，诊断准确性达８７ ．３ ％ ，而７６ ．０９ ％ 的良性肺病患者三项指标均为阴性。结论：对影像学可疑肺部肿瘤的患者进行支气管肺胞灌洗检测 Ｃ Ｅ Ａ、β２ － Ｍ Ｇ 以及瘤细胞学等三项联合，对诊断与鉴别诊断支气管肺癌有重要参考价值，尤其对周围型肺癌，纤维支气管镜检查肉眼无明显病变而临床可疑者更具重要价值。

Objective:To study the diagnostic value of the combined tumer markers in bronchoalveolar lavage fluids(BALFs) to lung cancer.Method:Flexible fiberoptic bronchoscopy was adopted and the BALFs were collected.Carcinoembryonic antigent (CEA)and β 2 -Microgobulin( β 2 -MG) in the BALFs were measured and statistically analyzed after being adjusted by potassium ion (K +).Results:CEA/K +and β 2 -MG/K +in the BALFs from the lung cancer group were significantly higher than those of the BALFs from the benign pneumopathy group with a great significant postive ratio.If CEA/K +and cancerous cells were jointly tested,93 75%cancerous patients were positive to at least one or more index of these three tests .The ratio of accurate diagnosis was 87.32%.On the other hand,the three tests in 76.09%patients of the benign pneumopathy were negative.Conclusions:The combined measurement of CEA, β 2 -MG and cancerous cells in BALFs has a very important value in the diagnosis of lung cancer for the patients being suspected by iconography,especially for the periphery lung cancer and the suspectable patients without any lesion under macroscopy,who were suspected by clinical manifestation