血清CA153在肺部良、恶性疾病鉴别诊断中的意义

Signifance of serum CA153 in the differential diagnosis between benign and malignant lung diseases

目的 :探讨血清CA15 3作为肿瘤标志物在肺部良、恶性疾病鉴别诊断中的临床意义 ,以及在肺癌病情判断中的临床应用价值。方法 :采集有肺部疾病入院患者的血清样本共 12 4份 ,其中肺癌 74份 ,肺部良性疾病(BLD) 5 0份 ,用免疫放射法检测其血清CA15 3、CEA的含量。结果 :肺癌患者血清CA15 3总阳性率 6 2 .6 8%,其中鳞癌 5 0 %,腺癌 75 %,小细胞肺癌 5 0 %,明显高于BLD组的 12 %(P <0 .0 0 1) ;血清CA15 3诊断肺癌的敏感度和特异度分别为 6 2 .6 8%和 88%,血清CEA的敏感度和特异度分别为 45 .0 7%和 98%,血清CA15 3敏感度明显优于血清CEA(P <0 .0 5 ) ,而特异度差别无显著性 (P >0 .9) ;对于不同的细胞亚型 ,肺腺癌患者血清CA15 3含量明显高于其他肺癌组 (P <0 .0 5 ) ;血清CA15 3的含量和阳性率与肺癌临床分期有关 ,期别越高其含量和阳性率越高 (P <0 .0 5 ) ,其早期诊断阳性率为 5 0 %;随访化疗患者 ,血清CA15 3的含量与疗效呈负相关。结论 :血清CA15 3对肺癌的诊断及病情预后判断有较高的临床价值 ,可以取代血清CEA作为检测肺癌 ,尤其是肺腺癌新的血清肿瘤标志物。

Purpose:To study the clinical significance of a tumor marker, serum CA153(sCA153), in the differential diagnosis between benign and malignant lung diseases, and in the evolution of lung cancer. Methods:124 serum samples was collected from 124 in-ward patients. Among them, 74 patients had lung cancer, and 50 patients had benign lung diseases (BLD). The concentrations of sCA153 and serum CEA (sCEA) were determined by immunoradiometric assay method.Results:In the lung cancer group, the total positive rate of sCA153 was 62.68%, which was evidently higher than that in BLD group(P<0.001). In the lung cancer group, the positive rates of sCA153 in different patients with different cell-types of lung cancer were as follows: squamous cell carcinoma 50%, adeonocarcinoma 75%, small-cell lung cancer 50%. The sensitivity and specificity of sCA153 in diagnosing lung cancer were respectively ,62.68% and 88%. The sensitivity and specificity of sCEA were respectively 45.07% and 98%. The sensitivity of sCA153 was significantly higher then that of sCEA(P<0.05), but there was no difference in the specificity between sCA153 and sCEA (P>0.9). In the different cell types of lung cancer patients, the concentration of sCA153 in lung adenocarcinoma patients was increased much more than that of other lung cancer groups (P<0.05). The concentration and the sensitivity of sCA153 were relative to the clinical stage of lung cancer and the more advanced the stage, the higher the level of sCA153 (P<0.05), the positive rate of sCA153 was 50% in diagnosing early-stage lung cancers. Follow-up of the patients treated with chemotherapy showed that the concentration of sCA153 was inversely related to the results. Conclusions:CA153 has high clinical value in the diagnosis and prognosis of lung cancer, and can be regarded as a new tumor marker in detecting lung cancer, especially in adenocarcinoma, instead of CEA.