多项血清肿瘤标志物联合检测在肺癌诊断中的应用价值

The application value of combined detection of serum tumor markers in the diagnosis of lung cancer

目的探讨血清癌胚抗原(CEA)、糖类抗原153(CA153)、糖类抗原125(CA125)、糖类抗原199(CA199)联合检测在肺癌诊断中的价值。方法采用直接化学发光法测定128例肺癌患者、84例肺良性疾病患者和30例体检健康者血清CEA、CA153、CA125、CA199的表达水平。结果肺癌组血清CEA、CA153、CA125、CA199水平明显高于肺良性疾病组及健康对照组(P<0.05);肺癌组血清CEA有较高的灵敏度(51.56%)与特异度(92.11%);联合检测最优化的组合为CEA+CA125+CA199、CEA+CA125,灵敏度分别为75.00%、64.84%。结论单项肿瘤标志物对肺癌均有一定的辅助诊断价值,联合检测对肺癌诊断的灵敏度和准确度有所提高,但其特异度相应下降,临床诊断需注意分析是否有假阳性的发生。血清CEA、CA125及CA199的联合检测可提高肺癌诊断的灵敏度。

Objective To explore the application value of combined detection of serum carcinoembryonic antigen（CEA）,carbo-hydrate antigen 1 53（CA1 53）,carbohydrate antigen 125（CA125）and carbohydrate antigen 1 99（CA1 99）in the diagnosis of lung canc-er.Methods The direct chemiluminescence assay was used to detect the expression levels of serum CEA,CA1 53,CA125 and CA1 99 in 128 cases of patients with lung cancer,84 cases of patients with lung benign disease and 30 cases of healthy individuals. Results The expression levels of serum CEA,CA1 53,CA125,CA1 99 in the lung cancer group was significantly higher than those in the lung benign disease group and the healthy control group（P 〈0.05）.The sensitivity and specificity of serum CEA was high in the lung cancer group,which was 5 1.56% and 92.1 1%,respectively.The optimized group of combined detection was CEA ＋CA125＋CA1 99 and CEA＋CA125,and the sensitivity was 75.00% and 64.84%,respectively.Conclusion Single tumor markers have certain auxiliary value in diagnosing lung cancer.Combined detection could increase diagnostic sensitivity and accuracy for lung cancer,but its specificity may decrease accordingly,so clinical diagnosis should pay attention to whether there is the occurrence of false-positive.The combined detection of serum CEA,CA125 and CA1 99 could improve diagnostic sensitivity of lung cancer.