支气管肺泡灌洗液和血清肿瘤标志物检测在肺癌诊断中的应用

Application of bronchoalveolar lavage fluid and serum tumor markers detection on diagnosis of lung cancer

目的探讨检测支气管肺泡灌洗液和血清肿瘤标志物在肺癌诊断中的应用。方法选择2013年1-12月在邯郸市第一医院治疗的58例肺癌患者以及42例肺部良性病变患者,检测并分析患者支气管肺泡灌洗液以及血清中的CEA、Cyfra21-1以及NSE水平。结果肺癌患者支气管肺泡灌洗液中CEA[（255.3±89.4）ng/m L]、Cyfra21-1[（244.1±79.2）ng/m L]、NSE[（75.2±21.1）ng/m L]水平均显著高于血液中[（61.7±22.3）、（16.1±4.9）、（31.5±11.4）ng/m L]（P〈0.01）,肺部良性病变患者支气管肺泡灌洗液中CEA[（14.1±4.8）ng/m L]、Cyfra21-1[（11.6±3.6）ng/m L]、NSE[（20.2±6.9）ng/m L]水平均显著高于血液中[（3.2±1.0）、（3.1±0.9）、（12.1±3.8）ng/ml]（P〈0.01）;肺癌患者支气管肺泡灌洗液以及血液中CEA、Cyfra21-1、NSE水平均显著高于肺部良性病变患者（P〈0.01）。CEA在腺癌水平最高,Cyfra21-1在鳞癌水平最高,NSE在小细胞癌的水平最高（P〈0.01）。随着病理分期的提高,支气管肺泡灌洗液以及血液中肿瘤标志物的水平均显著升高（P〈0.01）。支气管肺泡灌洗液CEA、Cyfra21-1对肺癌诊断的敏感性和准确性显著高于血液检测结果（P〈0.01）。支气管肺泡灌洗液联合血清中CEA＋Cyfra21-1＋NSE检测的敏感性最高（P〈0.01）。结论肺癌患者支气管肺泡灌洗液中肿瘤标志物水平显著高于血液中水平,并且联合检测支气管肺泡灌洗液以及血液中的肿瘤标志物能够显著提高对肺癌诊断的敏感性。

Objective To discuss the application of bronchoalveolar lavage fluid and serum tumor markers detection in the diagnosis of lung cancer. Methods From January to December 2013, in the First Hospital of Handan City, 58 patients with lung cancer and 42 patients with benign lung lesions were selected. CEA, Cyfra21-1 and NSE levels of bronchoalveolar lavage fluid and blood were detected. Results CEA [（255.3±89.4）ng/m L], Cyfra21-1 [（244.1±79.2）ng/m L]and NSE [（75.2±21.1）ng/m L] levels in bronchoalveolar lavage fluid from lung cancer patients were higher than those in blood [（61.7±22.3）,（16.1±4.9）,（31.5±11.4）ng/m L]（P 〈0.01）; and CEA [（14.1±4.8）ng/m L], Cyfra21-1 [（11.6±3.6）ng/m L]and NSE [（20.2±6.9） ng/m L] levels in bronchoalveolar lavage fluid from benign lung lesions patients were higher than those in blood（P 〈0.01）; CEA, Cyfra21-1 and NSE levels in bronchoalveolar lavage fluid and blood from lung cancer patiens were higher than those from benign lung lesions patients [（3.2±1.0）,（3.1±0.9）,（12.1±3.8）ng/ml]（P〈 0.01）; CEA level in adenocarcinoma was the highest, Cyfra21-1 level in squamous cell carcinoma was highest, and NSE level in small cell carcinoma was highest. With the improvement of the pathological staging, average bronchoalveolar lavage fluid and blood tumor markers were significantly increased（P 〈0.01）. Sensitivity and accuracy of CEA, Cyfra21-1 in bronchoalveolar lavage fluid were higher than those in serum（P 〈0.01）. Sensitivity of CEA＋Cyfra21-1＋NSE in bronchoalveolar lavage fluid and blood was highest（P 〈0.01）. Conclusion Tumor marker levels of bronchoalveolar lavage fluid from patients with lung cancer is significantly higher than those in blood, and combined detection of bronchoalveolar lavage fluid and blood tumor markers can significantly improve the sensitivity of diagnosis of lung cancer.