血清肿瘤相关抗原联合检测诊断肺癌的临床应用研究

Clinical research of serum tumor associated antigen combined bection in diagnosis of lung cancer

目的：探讨血清肿瘤相关抗原细胞角蛋白19片段抗原21-1（CYFRA21-1）、癌胚抗原（CEA）、胃泌素释放肽前体31-98（Pro-GRP31-98）联合检测对肺癌早期诊断的临床应用价值。方法：选取102例肺癌患者（恶性肿瘤组）、50例肺部良性病变患者（良性对照组）及50例健康体检者（健康对照组）为研究对象，应用电化学发光法检测其血清CYFRA21-1、CEA，酶联免疫法检测Pro-GRP31-98水平，统计分析血清CYFRA21-1、CEA、Pro-GRP31-98在各组中的表达，研究血清CYFRA21-1、CEA、Pro-GRP31-98水平与肺部良恶性疾病的相关性。结果：肺癌组患者CYFRA21-1、CEA、Pro-GRP31-98水平显著高于肺部良性对照组及健康对照组，差异有统计学意义（均P〈0.01）；肺癌组患者血清CYFRA21-1、CEA、Pro-GRP31-98水平与患者性别、年龄无明显相关，组内分别比较差异无统计学意义（P〉0.05），与病理组织学分型、临床分期、合并胸水、淋巴结转移、复发及治疗后明显相关，组内分别比较差异有统计学意义（均P〈0.05）；CYFRA21-1、CEA、Pro-GRP31-98诊断肺癌的敏感性分别为59.80%、52.94%、50.00%，准确性分别为70.39%、66.45%、64.47%；CYFRA21-1＋CEA、CYFRA21-1＋Pro-GRP31-98、CEA＋Pro-GRP31-98诊断肺癌的敏感性分别为70.59%、71.57%、68.63%，准确性分别为76.97%、76.97%、75.66%，而三项肿瘤相关抗原联合检测诊断肺癌的敏感性、准确性明显提高，分别达到96.07%、92.76%，与各单项及两两组合检测比较差异有统计学意义（P〈0.05）。结论：血清肿瘤相关抗原联合检测可以明显提高诊断肺癌的敏感性及准确性，有利于早期诊断、临床早期干预，同时对判断组织学分型、临床分期、监控转移、复发及预后具有指导意义。

Objective：To explore the level serum tumor associated antigen antigen of cytokeratin 19 fragment （CYFRA21 1）, 21-1 carcinoembryonic antigen （CEA, gastrin-releasing peptide precursor, 31-98 （Pro- GRP31-98）so as to detect the clinical application value of early diagnosis of lung cancer. Methods：102 cases of patients with lung cancer （malignant tumor group）, 50 patients with lung benign lesions （benign group） and 50 cases of healthy physical examination （healthy control group）was selected, application of electrochemical luminescence method to detect the serum CYFRA21-1, CEA, enzyme-linked immunoassay detection Pro-GRP31-98 levels, a statistical analysis of serum CYFRA21-1, CEA, Pro-GRP31-98, expressed in each group in the study of serum CYFRA21-1, CEA, Pro-GRP31-98 level and the correlation of lung benign and malignant diseases.Results：Group of patients with lung cancer, CEA, Pro -GRP31 CYFRA21-1-98 were significantly higher than that of benign lung control group and healthy control group, difference was statistically significant （al P〈0.01）;Lung cancer patients serum CYFRA21-1, CEA, Pro-GRP31-98 levels, with the patient, related to gender, age, without apparent differences were compared in the group with no statistical significance （P〉0.05）, credits and histopathologic type, clinical stage, merger pleural effusion, and lymph node metastasis and recurrence after treatment significantly related, were compared in the group difference was statistical y significant （al P〈0.05）;, CEA, Pro-GRP31 CYFRA21-1-98, the sensitivity of the diagnosis of lung cancer were 59.80%, 52.94%, 50.00%, the accuracy is 70.39%, 66.45%and 64.47%respectively;CYFRA21-1＋＋Pro-GRP31 CEA, CYFRA21-1-98, CEA＋Pro-GRP31-98 the sensitivity of the diagnosis of lung cancer are 70.59%, 71.57%and 70.59%respectively, the accuracy is 76.97%, 76.97%and 75.66%respectively, and the sensitivity of the three tumor related antigen assay for diagnosis of lung cancer, obviously improve the accuracy, reached 96.07%and 92.76%respectively, compared with the single and two combination detection difference was statistical y significant （P〈0.05）. Conclusions：Serum tumor associated antigen joint detection can significantly improve the sensitivity and accuracy of diagnosis of lung cancer, is helpful for early diagnosis, clinical intervention, to determine the credit type, clinical stage, at the same time monitoring metastasis, recurrence and prognosis.