联合检测血清、痰液中CEA,SA与SP-A对肺癌诊断的临床研究

Diagnosis Value to Lung Cancer Combined Determination of CEA,SA and SP-A in Serum and Sputum

目的 通过联合检测血清和痰液中CEA,SA（唾液酸,N-乙酰神经氨酸）,SP-A（肺表面活性物质相关蛋白A）的表达水平,探讨其对肺癌诊断的价值.方法 应用酶联免疫吸附法（ELISA）对65例肺癌、55例肺部良性疾病患者及31例健康查体者的血清及痰液进行相关检测.结果 肺癌患者血清及痰液中三项肿瘤标志物平均含量均高于其它肺良性疾病患者（P＜0.01）;痰液中三种标志物明显高于血清中的含量（P＜0.05）;联合检测两项及三项阳性者均使血清和痰液诊断肺癌的特异度提高;肺癌组血清和痰液中三项肿瘤标志物的表达水平,Ⅲ期,Ⅳ期患者均高于Ⅰ＋Ⅱ期患者（TNM分期）.结论 联合检测血清和痰液中的标志物有助于肺癌的诊断;SA和SP-A联合检测可以显著提高敏感度、特异度和准确度,有助于肺癌诊断.

Objective To investigate the values of carcinoembryonic antigen （CEA）,saliva acid （SA） and surfactant-associated protein A （SP-A） in the diagnosis of lung cancer. Methods The concentrations of CEA,SA and SP-A in the serum and sputum were measured in 65 patients with primary lung cancer, 55 patients with benign pulmonary diseases and 31 healthy persons by enzyme-linked immunosorbent assay. Results The levels of three tumor markers in the serum and sputum from cancer patients were significantly higher than those with benign ones or healthy persons （P〈0. 01）. The concentrations of three tumor markers were higher in sputum than in the serum with a significant difference（P〈0.05）. If two or three of the three were positive ,the serum and sputum concentration showed higher specificity for the diagnosis of lung cancer. The levels of three tumor markers in the serum and sputum were higher in stage III or stage IV of cancer patients than in stage I＋II （TNM stage）. Conclusion Combined determination of CEA,SA and SP-A in serum and sputum could increase the sensitivity,the specificity and the accuracy,and might be useful to the diagnosis of lung cancer.