CEA、AFP、CA199、CA153在肺癌诊断中的临床应用价值

Clinical value of CEA, AFP, CA199 and CA153 in the diagnosis of lung cancer

目的分析癌胚抗原(carcinoembryonic antigen,CEA)、甲胎蛋白(alpha fetoprotein,AFP)、糖链抗原199(carbohydrate antigen 199,CA199)、CA153对肺癌的诊断价值。方法选取我院经影像学、病理证实肺癌患者70例(肺癌组)、肺部良性病变患者60例(肺部良性病变组)及健康体检人员65例(正常对照组),通过全自动电化学发光仪测定各组CEA、AFP、CA199及CA153水平,比较各组上述肿瘤标志物阳性率,并比较不同肿瘤标志物对肺癌诊断的灵敏度、特异性及准确度。结果肺癌组、肺部良性病变组及正常对照组间血清CEA、AFP、CA199、CA153检测结果比较,差异均具有统计学意义(P均<0.05);肺癌组血清CEA、AFP、CA199、CA153检测水平均明显高于肺部良性病变组与正常对照组,差异均有统计学意义(P均<0.01);肺部良性病变组CEA、AFP、CA153水平均明显高于正常对照组(P均<0.05),且差异均有统计学意义(P均<0.05)。不同组织分型肺癌组CEA、AFP、CA199、CA153比较差异均无统计学意义(P均>0.05)。肺癌组、肺部良性病变组及正常对照组间CEA、AFP、CA199、CA153阳性检出率比较,差异均有统计学意义(P均=0.000);肺癌组各肿瘤标志物阳性检出率均高于肺部良性病变组及正常对照组,且差异均有统计学意义(P均<0.05);肺部良性病变组与正常对照组间各肿瘤标志物阳性检出率差异均无统计学意义(P均<0.05)。4项肿瘤标志物单独检测诊断肺癌的灵敏度、准确度均较低,但特异性较高,均>95.00%,4项联合检测可提高诊断肺癌的灵敏度及准确度。结论 CEA、AFP、CA199、CA153对肺癌诊断有一定的价值,各肿瘤标志物联合检测,能有效提高肺癌诊断准确度。

Objective To analyze the value of carcinoembryonic antigen （CEA）, alpha fetoprotein （AFP）, carbohydrate antigen 199（CA199） and CA153 in the diagnosis of lung cancer. Methods 70 cases of patients with lung cancer confirmed by imaging and pathology , 60 cases of patients with lung benign lesions and 65 cases of healthy persons were selected as study subjects in our hospital and which were respectively di-vided into lung cancer group, benign lung group and normal group. The levels of CEA, AFP, CA199 and CA153 were measured by automatic electrochemical luminescence instrument. The positive rates of tumor markers mentioned above were compared among the groups. The sensitivity , specificity and accuracy of differ-ent tumor markers in diagnosis of lung cancer were compared. Results There were statistical significance in the differences of CEA, AFP, CA199 and CA153 levels among three groups （Pall〈0.05）. The levels of CEA, AFP, CA199 and CA153 in cancer group were all higher than that of benign lung group and normal group, and the differences all had statistical significance （Pall〈0.01）. The levels of CEA, AFP, CA153 in benign lung group were all higher than that of control group, and the differences all had statistical significance（Pall〈0.05）. There was no statistical significance in the differences of CEA, AFP, CA199 and CA153 levels among different tissue typing groups（Pall〉0.05）. There were statistical significance in the differences of positive rates of CEA, AFP, CA199 and CA153 among three groups （Pall=0.000）. The positive rates of CEA, AFP, CA199 and CA153 in cancer group were all higher than that of control group and benign lung group , and the differences all had statistical significance（Pall〈0.05）. There was no statistical significance in the differences of positive rates of all the index between begin lung group and control group （Pall〉0.05）. The sensitivity and accuracy of 4 tu-mor markers in lung cancer diagnosis were all lower, but specificity were all higher, which were all higher than 95.00%, and combined detection could improve the sensitivity and accuracy. Conclusion CEA, AFP, CA199 and CA153 have certain value in the diagnosis of lung cancer , especially the combined detection of tu-mor markers can effectively improve the accuracy of diagnosis of lung cancer.