血清TPS、NSE、CEA联合检测与小细胞肺癌的临床关系

THE CLINICAL RELATION OF TISSUE POLYPEPTIDE SPECIFIC ANTIGEN,NEURON-SPECIFIC ENOLASE,CARCINOEMBRYONIC ANTIGEN IN SMALL CELL LUNG CANCER

目的探讨血清组织多肽特异性抗原(tissue polypeptide specific antigen,TPS)、神经元特异烯醇化酶(neuron-specific enolase,NSE)、癌胚抗原(carcinoembryonic antigen,CEA)水平对小细胞肺癌(small cell lung cancer,SCLC)的诊断价值。方法应用酶联免疫吸附测定法检测SCLC患者62例、肺良性疾病患者50例和健康对照者70例血清TPS水平,同时采用电化学发光法检测血清NSE和CEA水平。结果 SCLC组TPS、NSE和CEA血清水平明显高于肺良性疾病组和健康对照组(P<0.01);广泛期SCLC患者血清TPS和NSE明显高于局限期患者(P<0.05)。治疗后不同预后患者TPS和NSE浓度差异有统计学意义(P<0.01)。以TPS、NSE水平为指标,诊断SCLC治疗前的敏感度分别为68.1%、65.4%,高于CEA。多项联合检测时,以NSE+TPS组合的敏感度最高(88.4%),此外,发生转移的SCLC血清中TPS、NSE水平高于未转移组。结论血清TPS、NSE和CEA对于SCLC的早期诊断有一定价值,联合检测有明显互补性,以TPS+NSE联合检测的临床价值最好,其水平与肺癌转移密切相关。

Objective To investigate the diagnostic value of tissue polypeptide specific antigen （ TPS）, neuron - specific enolase （ NSE ）, carcinoembryonic antigen （ CEA ） in serum of small cell lung cancer （SCLC） patients. Methods Serum levels of TPS was detected using enzyme linked immuno - sorbent assay and serum levels of NSE and CEA was detected using electrochemiluminescence （ECL） in 62 SCLC patients, 50 pulmonary benign disease patients and 70 normal healthy people. Results The levels of TPS, NSE and CEA in the serum of SCLC group were significantly higher than those in pulmonary benign disease and heahy group （ P 〈 0.01 ）. The levels of TPS and NSE in the serum of extensive stage small cell lung cancer patients were significantly higher than those in limited stage small cell lung cancer （ P 〈 0.05 ）. The level of TPS and NSE showed statistical significance among SCLC patients with different prognosis after therapy （P 〈0.01 ）. With the TPS and NSE levels as an index of diagnosis of SCLC before treatment, the sensitivity and specificity were 68.1% and 65.4%, respectively, higher than that of CEA. In a number of combined detection, the TPS ＋ NSE showed the highest sensitivity of 88.4%. In addition, the TPS and NSE levels in the serum of metastasis group of SCLC were higher than that of the group with no metastasis. Conclusion Serum TPS, NSE, and CEA for early diagnosis of SCLC have a certain value. There is complementarity in the combined detection of the level of TPS, NSE and CEA, and their levels have close correlation with the histological grades and lymphoid nodule metastasis of lung cancer.