血清癌胚抗原和支气管肺泡灌洗液中癌胚抗原在肺癌诊断中的应用价值

Application of serum CEA and BALF-CEA on diagnosis of lung cancer

目的分析和评价血清和支气管肺泡灌洗液中,癌胚抗原(CEA)在肺癌诊断中的应用价值。方法收集2007年4月至2010年12月入住本院的肺癌病例120例,对照组为本院体检干部100例,两组性别、年龄均匹配,所有病例均经过支气管镜检和病理证实。检测病例组和对照组血清及支气管肺泡灌洗液(BALF)中的CEA水平。计量资料组间差异比较采用t检验,计数资料组间差异比较采用χ2检验。结果病例组血清CEA(Serum-CEA)和支气管肺泡灌洗液CEA(BALF-CEA)均显著高于对照组,差异有统计学意义(P<0.05),且随着临床分期的增高,血清CEA和BALF-CEA水平均有增高,组间比较差异有统计学意义(P<0.05);病例组BALF-CEA水平均明显高于血清CEA水平,差异有统计学意义(P<0.05)。应用血清CEA检测肺癌的特异性和灵敏性分别为68%和71%;应用BALF-CEA检测肺癌的特异性和灵敏性分别为72%和81%,联合检测的特异性和灵敏性分别是74%和88%。结论血清和支气管肺泡灌洗液中CEA在肺癌诊断中均有重要参考价值。联合检测血清CEA和BALF-CEA水平可明显提高诊断的灵敏度。

Objective To evaluate the clinical value of serum carcinoembryonic antigen（CEA） and bronchoalveolar lavage fluid（BALF）detection in the diagnosis of lung carcinoma.Methods 120 lung cancer patients who had undertaken bronchoscopic examination and biopsy examination were divided into observation group and control group.All subjects were measured with serum CEA and BALF concentration.Mean value comparison of the groups was conducted with single factor variance analysis,and the pairwise comparison was performed with LSD method.Results Serum CEA and bronchoalveolar lavage fluid CEA（BALF-CEA） were significantly higher in observation group than those of control group（P0.05）.It was observed that the serum CEA and BALF-CEA levels increased in the clinical stage.The serum CEA demonstrated a sensitivity of 71% and specificity of 68% for the diagnosis of lung cancer,while the BALF-CEA demonstrated a sensitivity of 74% and specificity of 88%.When serum CEA and BALF-CEA were determined in combination,the sensitivity for diagnosis of lung cancer was 88%,and the specificity was 74%.Conclusion Serum CEA and BALF-CEA were useful markers in diagnosis of lung cancer,especially when detecting in combination.