支气管肺泡灌洗液中肿瘤标记物检测对肺癌诊断的应用价值

Bronchoalveolar lavage fluid application value of tumor markers detection in lung cancer

目的探讨支气管肺泡灌洗液(BALF)中肿瘤标记物浓度检测在肺癌诊断、病理分型及临床分期中的应用价值。方法选择病理组织学和细胞学确诊的78例肺癌作为肺癌组,72例肺良性病变作为对照组,采用酶联免疫法,分别测定两组患者BALF及血清中CEA、可溶性细胞角蛋白19片段(CYFRA21-1)、NSE、鳞状上皮细胞癌相关抗原(SCC)的浓度。结果 (1)肺癌组血清中CEA、CYFRA21-1、NSE、SCC浓度明显高于对照组,两组比较差异显著(P<0.05);(2)肺癌组BALF中CEA、CYFRA21-1、NSE、SCC浓度明显高于对照组BALF中的浓度,两组比较差异显著(P<0.05);(3)肺癌组BALF中CEA、CYFRA21-1、NSE、SCC浓度明显高于血清中浓度,两组比较差异显著(P<0.05);(4)肺癌组患者血清及BALF中,CEA浓度在腺癌中最高,CYFRA21-1及SCC浓度在鳞癌中最高,NSE浓度在小细胞癌中最高,差异显著(P<0.05);(5)肺癌组BALF中CEA、CYFRA21-1、NSE、SCC的浓度在Ⅰ期与Ⅱ、Ⅲ、Ⅳ期肺癌之间比较差异均显著(P<0.05);Ⅱ、Ⅲ、Ⅳ期肺癌BALF中肿瘤标志物的水平较Ⅰ期患者显著升高(P<0.05)。结论 BALF中CEA、CYFRA21-1、NSE、SCC检测对肺癌的早期诊断优于血清。BALF中肿瘤标记物的检测对于推测病理类型、判断临床分期及预后有一定临床价值。

Objective To explore the value of tumor markers＇ concentration in bronchoalveolar lavage fluid（BALF） in lung cancer diagnosis and pathological types and clinical stages.Method 78 patients were diagnosed by histopathological and cytological results as lung cancer group,72 patients with benign lesions of the lung as control group,both groups were measured the concentration of carcinoembryonic antigen,soluble intracellular keratin 19 pieces,neuronspecific enolase,squamous cell carcinoma-related antigen by enzyme-linked immunosorbent assay in two groups of patients in BALF and serum.Results Serum CEA,CYFRA21-1,NSE,SCC concentration in lung cancer group were significantly higher than the control group with statistically significant（P〈0.05）.The CEA,CYFRA21-1,NSE,SCC concentration of BALF in lung cancer group were significantly higher than the control group with statistically significant（P〈0.05）.The CEA,CYFRA21-1,NSE,SCC concentration of lung cancer group in BALF were higher than in serum with statistically significant（P〈0.05）.The CEA levels in adenocarcinoma was the highest,the CYFRA21-1 and SCC in squamous cell carcinoma of the highest concentration,the NSE concentration was the highest in small cell lung cancer in serum and BALF from lung cancer patients with statistically significant（P〈0.05）.The concentration of CEA,CYFRA21-1,NSE,SCC in BALF on lung cancer stage Ⅰ and Ⅱ,Ⅲ,Ⅳ in lung Cancer Group showed a statistically significant difference（P〈0.05）;Compared with stageⅠ,patients on stage Ⅱ,Ⅲ and Ⅳ had higher markers levels in the BALF with statistically significant（P〈0.05）.Conclusion The detection of CEA,CYFRA21-1,NSE and SCC in BALF in early diagnosis of lung cancer is superior to serum.Detection of tumor markers in BALF has clinical value in speculating the pathology,clinical staging and prognosis.