多项指标联合鉴别诊断肺鳞癌与腺癌的病理研究

The pathological studies of multi-combined indicators in the differential diagnosis of lung squamous carcinoma and adenocarcinoma

目的探讨多项指标包括癌胚抗原(CEA)、P63蛋白、天门冬氨酸蛋白酶A(Napsin A)联合在肺鳞癌与腺癌的病理学鉴别诊断中意义。方法分析我院自2011年1月至2013年1月收治的92例肺癌患者,其中鳞癌49例及腺癌43例,采用酶联免疫吸附法(ELISA)和免疫放射分析法(IRMA)检测CEA、P63蛋白、Napsin A。结果①CEA、P63蛋白、Napsin A在鳞癌与腺癌中的阳性率显著不同,在统计学上具有显著性意义(P<0.05,0.005)。②腺癌转移癌中P63蛋白阳性率在原发性、转移性中比较,在统计学上具有显著性差异(P<0.005)。③CEA、P63蛋白、Napsin A三者联合检测腺癌的敏感性为95.9%,联合检测腺癌的敏感性为90.7%。结论 CEA、P63蛋白、Napsin A三种肿瘤标志物用于病理学鉴别诊断肺腺癌与鳞癌,三者联合检测敏感性高,在检测肺癌中具有一定的应用价值。

Objective To explore the meaning of the multi-combined indicators such as Carcinoembryonic antigen （CEA）,P63 protein,aspartic proteinase A （Napsin A）in the pathological differential diagnosis of lung squamous carci-noma and adenocarcinoma.Methods We analyzed 92 cases who had lung cancer from January 2011 to January 2013,in-cluding 49 squamous carcinoma cases and 43 adenocarcinoma cases.The CEA,P63 protein,Napsin A levels were inspec-ted by ELISA and IRMA detection.Results ①There were significantly differences of the positive rates of CEA,P63 protein,Napsin A between squamous carcinoma and adenocarcinoma （P 〈 0.05,0.005）.② There were significantly differences of the positive rates of metastatic adenocarcinoma cancer in case of the primary tumor and the metastatic tumor were compared （P 〈0.005）.③The sensitivity of the application of combined CEA,P63 protein,Napsin A detec-tion for adenocarcinoma was 95.9%,while the sensitivity of the combined detection for adenocarcinoma was 90.7%. Conclusion When the three tumor markers of CEA,p63 protein and Napsin A are employed in pathological differential diagnosis lung adenocarcinoma and squamous cell carcinomas,the sensitivity of the combined detection is high and of applicable meanings in the detection of lung cancer.