四种肿瘤标记物联合检测在肺癌诊断中的价值

The value of combination detection of four tumor markers in diagnosis of lung cancer

目的分析联合检测血清肿瘤标记物癌胚抗原(CEA)、神经特异性烯醇化酶(NSE)、肿瘤相关抗原125(CA125)、肿瘤相关抗原199(CA199)在肺癌诊断中的价值。方法分别检测86例肺癌患者、68例肺部良性病变患者、40例健康体检者的CEA、NSE、CA125和CA199水平,对结果进行分析。结果肺癌患者血清CEA、NSE、CA125和CA199水平明显高于肺部良性病变者和健康体检者(P<0.05),而肺部良性病变者与健康体检者间差异无统计学意义(P>0.05);单项肿瘤标志物CEA、NSE、CA125和CA199诊断肺癌的灵敏度分别为48.84%、38.37%、29.07%、18.60%;而联合检测诊断肺癌的灵敏度高达61.63%,联合检测的灵敏度明显优于各个单项肿瘤标志物,差异有统计学意义(P<0.05);腺癌中CEA水平明显高于小细胞癌和鳞癌(P<0.05);小细胞癌中NSE水平明显高于鳞癌和腺癌,差异有统计学意义(P<0.05);在肺癌的3种病理类型中,CA125、CA199水平差异无统计学意义(P>0.05)。结论 CEA水平与肺腺癌相关,NSE水平与小细胞癌相关,CA125、CA199水平与肺癌的病理组织类型无关;联合检测可作为肺癌早期诊断较为理想的监测指标。

Objective To analyze the value of combination detection of serum tumor markers including carcinoembryonic antigen （CEA） , neuro specific enolase （NSE） , cancer antigen 125 （CA125） , tumor associated antigen 199 （CA199） in diagnosis of lung cancer. Methods The serum levels of CEA, NSE, CA125 and CA199 were detected in 86 patients with lung cancer,68 patients with benign pulmonary diseases and 40 healthy subjects, and the examination results were analyzed and compared among the three groups. Results The serum levels of CEA,NSE,CA125 and CA199 in patients with lung cancer were significantly higher than those in patients with benign pulmonary diseases and healthy subjects （ P 〈 0.05 ）. However there were no significant differences in the serum levels of CEA, NSE, CA125 and CA199 between patients with benign pulmonary diseases and healthy subjects （ P 〉 0.05 ）. The detection sensitivity by single item tumor marker （ CEA, NSE, CA125, CA199） was 48.84% , 38.37%, 29.07%, 18.60% , respectively, however, which by combination detection reached up to 61.63% ,and the detection sensitivity by combination detection was suprior to that by single item tumor maker （P 〈 0.05 ）. The serum levels of CEA in adenocarcinoma were significantly higher than those in small cell carcinoma and squamous cell carcinoma （ P 〈 0.05 ） , moreover, the serum levels of NSE in small cell carcinoma were significantly higher than those in squamous cell carcinoma and adenoearcinoma（ P 〈 0.05 ）. There were no significant differences in the serum levels of CA125 and CA199 among the three kinds of pathological types of lung cancer （ P 〉 0.05 ）. Conclusion The levels of CEA are con＇elated to lung adenocarcinoma, and the levels of NSE are related with small cell lung carcinoma, however, the levels of CA125 and CA199 are not correlated to pathological type of lung cancer. The combination detection can be regraded as an ideal monitoring index for early diagnosis of lung cancer.