血清肿瘤标志物与肺癌高危因素的临床分析

Analysis of lung cancer risk factors and serum tumor markers

目的探讨血清肿瘤标记物在高危及肺癌人群中的应用价值,及肺癌高危因素的检测方法。方法选取成都市第三人民医院2013年1月至2014年2月住院患者230例;依据纳入标准进入高危因素组随访观察;对照人群为70例良性疾病患者;采用电化学发光免疫法分析血清肿瘤标志物CEA、细胞角蛋白19片段、神经特异性烯醇化酶、鳞状上皮细胞癌抗原及铁蛋白的水平。结果纳入高危因素的患者230例,其中经气管镜或胸腔镜即确诊肺癌160例,6~22个月期间随访病例70例,后期确诊肺癌12例;因肺部结节病变入院,确诊肺癌88例,占位病变中有8例随访观察中确诊肺癌;多项肿瘤标志物联合铁蛋白增高,能有效判定肺部结节的良恶性(P<0.05)。胸部结节合并铁蛋白增高对诊断肺癌具有显著意义(P=0.021)。结论肿瘤标志物和铁蛋白增高是肺癌的独立危险因素。单纯铁蛋白增高对判定肺部占位的良恶性并无意义,如联合肺部占位结节检测肿瘤良恶性,其诊断意义可大为提高。

Objective To discuss the value of serum tumor markers in people at high risk of lung cancer and explore the detection methods of lung cancer risk factors. Methods 230 cases were randomly selected in hospitalized patients with lung cancer risk factors from Jan 2013 to Feb 2014.70 cases with benign disease were selected as control group. Serum tumor markers were detected by electrochemilurninescence immunoassay. Results 160 cases were diagnosed lung cancer by bronehoscope or thoracoscopy. 12 cases were diagnosed lung cancer in following 6-22 months. In the patients hospitalized due to lung nodules, 88 cases were diagnosed lung cancer and 8 cases were diagnosed lung cancer in following period. The increased levels of several serum tumor markers and serum ferritin could distinguish benign and malignant pulmonary nodule（ P〈 0.05）. Pulmonary nodule combined with highly serum ferritin detection had significant value in diagnosis lung cancer（ P = 0. 021 ）. Conclusion Highly tumor marker and serum ferritin are significant risk factors. Independent Ferritin detection is not statistically significant in benign or malignant tumor. The joint detection of serum ferritin and pulmonary nodules has clinical diagnostic value in lung cancer.