肿瘤标志物蛋白芯片中肺癌相关指标的筛选优化

Screening and optimizing the lung cancer related tumor markers from multi-tumor marker protein chip

目的:分析多种肿瘤标志物(Tumor marker,TM)与肺癌的相关性,筛选相关指标,为建立检测肺癌的小型蛋白芯片提供依据。方法:使用TM蛋白芯片系统,检测311例肺癌患者血清中多种TM:癌抗原125(Cancer antigen 125,CA125)、癌抗原153(Cancer antigen 153,CA153)、糖链抗原199(Carbohydrate antigen,CA199)、癌胚抗原(Carcinoembryonic antigen,CEA)、甲胎蛋白(Alpha fetoprotein,AFP)、铁蛋白(Ferritin,FER)、游离型前列腺特异性抗原(Free prostate specific antigen,free-PSA)及前列腺特异性抗原(Prostate specific antigen,PSA)的水平。筛选出肺癌中阳性率高的的指标,采用Kappa检验比较其与TM蛋白芯片系统检测结果的一致性,寻找最佳联检组合。结果:311例肺癌患者中TM升高主要集中在4项指标:CEA(41.5%)、CA153(15.2%)、CA199(20.9%)、CA125(37.0%);Kappa检验得出,一致性极强的小型组合有5种,使用成本-效果分析法得出最佳组合为CA125+CEA。结论:血清CEA和CA125水平升高对肺癌的诊断有较高的临床价值,选择CA125+CEA联合检测,可以在不降低检出率的情况下降低检测成本。

Objective：To screen and optimize the lung cancer related tumor markers from multi-tumor marker protein chip.Methods：With the multi-tumor marker protein chip,the sera of 311 patients with lung cancer were detected for multi-tumor markers including carcinoembryonic antigen（CEA）,alpha fetoprotein（AFP）,carbohydrate antigen 199（CA199）,cancer antigen 153（CA153）,cancer antigen 125（CA125）,prostate specific antigen（PSA）,free-PSA,and ferritin.Lung cancer related parameters were analyzed by Kappa test and cost-effectiveness analysis.Results：There were four kinds of tumor markers which were apparently increased in the serum among the 311 lung cancer patients：CEA（41.5%）,CA153（15.2%）,CA199（20.9%）,and CA125（37.0%）.Five tumor marker combinations were found to be strongly consistent with the results of multi-tumor marker protein chip by Kappa test,and the combination of CEA with CA125 was proved to be the best by cost-effectiveness analysis.Conclusion：The combined detection of sera CEA and CA125 is helpful to diagnose lung cancer,which is consistent with the positive rate of diagnosis by using multi-tumor marker protein chip and the two combination test can cut down the cost of diagnosis of lung cancer.