肿瘤标志物联合诊断对转移性肺癌的临床意义

Clinical Significance of Unified Tumor Markers in Diagnosis of Metastatic Lung Cancer

目的探讨癌胚抗原(carcino embryonic antigen,CEA)、血细胞角蛋白19片段(cytokeratin-19-fragment,CY21)、神经元特异性烯醇化酶(neuron specific enolase,NSE)和糖类抗原125(carbonhydrate antigen,CA125)对转移肺癌的临床诊断价值。方法采用电化学发光免疫分析技术(electrochemiluminescenceimmunoassay,ECLIA)法测定59例正常健康被试(对照组)、59例非转移肺癌患者、50例转移肺癌患者血清中的CEA、CY21、NSE和CA125水平。结合临床资料,分析其临床诊断价值。结果与对照组比较,两种肺癌患者中4种肿瘤标志物含量均有升高趋势,非转移肺癌患者血清CEA、NSE水平变化具有统计学差异(P<0.05),转移肺癌患者4种肿瘤标志物含量均显著增高(P<0.01或P<0.05);与非转移肺癌患者比较,转移肺癌患者四种肿瘤标志物含量仍均明显增高(P<0.01或P<0.05);单独检测血清CEA、CY21、NSE和CA125对转移肺癌诊断的阳性率分别为64.00%、44.00%、48.00%和50.00%,联合检测达到94.00%。结论 4项肿瘤标志物联合检测可明显提高转移肺癌诊断的阳性率,有重要的临床应用价值。

Objective To discuss the clinical diagnostic value of carcino embryonic antigen（CEA）,cytokeratin-19-fragment（CY21）,neuron specific enolase（NSE） and carbonhydrate antigen（CA125） on metastatic lung cancer. Methods Serum CEA,CY21,NSE and CA125 levels of 59 healthy control subjects,59 patients with non-metastatic lung cancer and 50 patients with metastatic lung cancer were determined by electrochemiluminescenceimmunoassay（ECLIA）.The diagnostic value of these markers was evaluated based on the clinical materials. Results Compared with the control group,the levels of 4 tumor markers in the two patient groups were higher,and the difference was significant in CEA and NSE levels of non-metastatic lung cancer group（P0.05） and all the 4 markers in metastatic lung cancer group（P0.01 or P0.05）.Compared with the non-metastatic lung cancer group,the levels of 4 tumor markers were significantly higher（P0.01 or P0.05）.The sensitivity of CEA,CY21,NSE,CA125 and unified detection of the 4 markers in the diagnosis of metastatic lung cancer was 64.00%,44.00%,48.00%,50.00% and 94.00% respectively. Conclusion Unified detection of the 4 tumor markers together can increase the sensitivity in the diagnosis of metastatic lung cancer and has important application value in clinic.