不同标本肿瘤标志物联合检测对肺癌的诊断价值

Diagnostic value of combined tumor markers assays in different samples patients with lung cancer

目的:检测血液、痰液、支气管肺泡灌洗液(BALF)、胸腔积液四种标本中癌胚抗原(CEA)、癌抗原125(CA125)、癌抗原199(CA199)和细胞角蛋白21-1片段(CYFRA21-1)的浓度,探讨不同标本肿瘤标志物(TM)联合检测在肺癌诊断中的意义。方法:采用化学发光免疫分析法检测52例肺癌和46例肺部良性病变患者血液、痰液、BALF、胸腔积液中CEA、CA125、CA199和CYFRA21-1的浓度。结果:52例肺癌患者血液、痰液、BALF、胸腔积液中四种TM联合检测的阳性率分别为69.2%、90.4%、88.5%和82.1%;而46例肺部良性病变患者的阳性率分别为19.6%、26.1%、23.9%、21.7%。经统计学检验两组间四种标本TM联合检测阳性率差异有统计学意义(P<0.05)。肺癌组不同标本之间TM联合检测的阳性率差异有统计学意义(P=0.02);痰液和BALF标本TM联合检测较血液临床意义更大(P=0.01;P=0.02)。联合两个或三个标本检测与单个血液标本检测相比,其差异有统计学意义(P<0.05)。结论:不同标本肿瘤标志物CEA、CA125、CA199和CYFRA21-1联合检测对肺癌的诊断具有一定的意义。联合不同标本检测四种TM能提高肺癌诊断的敏感性。

Objective：To evaluate the clinical significance of assaying carcino - embryonic antigen （CEA）, car-bohydrate antigens （ CA125 and CA19 - 9） and Cytokeratin 19 fragment （ CYFRA21 - 1 ） in serum, sputum, broncho - alveolar lavage fluid （BALF） and pleural effusion of patients with lung cancer. Methods ： Using the method of che-mi-luminescent enzyme immunoassay with a commercially available enzyme immunoassay kit, 52 cases with lung cancer and 46 cases with benign lung diseases underwent assay of CEA, CA125, CA199 and CYFRA21-1 in serum, sputum, BALF and pleural effusion. Results：Of the 52 cases with lung cancer,the positive percentages of combination assays of CEA, CA125,CA199 and CYFRA21-1 were as follows：69.2% in serum,90.4% in sputum,88.5% in BALF and 82.1% in pleural effusion, respectively; But the positive percentages of those with benign lung diseases were 19.6% ,26.1% ,23.9% ,21.7%, respectively. The positive percentages of combination of these tumor markers assays in patients with lung cancer was significantly higher than in those with nonmalignant respiratory diseases （ P 〈 0.05 ）. Among the 52 patients with lung cancer, the diagnostic sensitivity of combination of these tumor markers assays in sputum or BALF was significantly higher than those in serum（ P = 0. O1 ;P = 0, 02 ）. Compared with the single ser-um samples that these tumor markers were measured, the combination of 2 or 3 of these samples could improve the sensitivity and accurate value in the diagnosis of lung cancer（P 〈0.05 ）. Conclusion：To assay CEA, CA125, CA199 and CYFRA21-1 in serum, sputum, BALF and pleura1 effusion was a valuable aid in diagnosis of lung cancer, and compared with the single serum sample that these tumor markers were measured, the combination of 2 or 3 of these samples could improve sensitivity and accurate value in the diagnosis of lung cancer.