血清肿瘤标记物联合动态检测对肺癌诊疗的价值研究

Clinical application of combined dynamic detection of serum tumor markers in the diagnosis and treatment of lung cancer

目的 研究血清肿瘤标记物糖类抗原（CA50）、鳞状上皮癌抗原（Scc-Ag）、胃泌素释放肽前体（ProGRP）联合动态检测对肺癌早期诊断和监控治疗的临床应用价值。方法 选取126例肺癌患者（肺癌组）、50例肺部良性病变患者（良性对照组）及50例健康体检者（正常对照组）为研究对象，采用电化学发光法及酶联免疫法分别检测其血清CA50、Scc-Ag、ProGRP水平。结果 ①肺癌患者血清CA50、Scc-Ag、ProGRP水平明显高于良性对照组和正常对照组（P〈0.01）；②肺癌高分期组、复发转移组治疗前血清CA50、Scc-Ag、Pro-GRP水平明显高于低分期组、无复发转移组及本组治疗后（P〈0.01）；③ CA50、Scc-Ag、ProGRP分别在肺腺癌、鳞癌、小细胞癌血清表达水平较高（P〈0.01）；④血清CA50、Scc-Ag、ProGRP诊断肺癌的敏感性分别为48.41%、52.37%、46.83%；特异性分别为96.00%、98.00%、94.00%；准确性分别为61.93%、64.77%、60.23%；三项肿瘤标记物联合检测诊断肺癌的特异性为86.00%，虽有所降低，但敏感性、准确性明显提高，分别为95.24%、92.61%，与各单项及两两组合检测比较差异均有统计学意义（P〈0.01）。结论 血清肿瘤标记物CA50、Scc-Ag、ProGRP可作为肺癌诊断的生物学指标，联合检测敏感性、准确性明显提高，有利于早期诊断，同时联合动态检测可辅助判断临床分期、组织学类型、复发转移、监控预后及指导治疗。

Objective To investigate the clinical application value of serum tumor marker carbohydrate antigen （CA50）, squamous cell carcinoma antigen（Scc-Ag）, gastrin-releasing peptide precursor （ProGRP） combined dynamic detection in the early diagnosis and monitoring of lung cancer.Methods A total of 126 cases of lung cancer （lung cancer group） and 50 cases of lung benign lesions （benign control group） and 50 cases of healthy physical examination （normal control group） were selected as the research objects. Serum tumor marker levels of CA50, Scc-Ag, ProGRP were measured with electrochemiluminescence and ELISA respectively.Results ① Serum CA50, Scc-Ag, ProGRP levels in lung cancer group were significantly higher than those in the benign control group and normal control （P〈0.01）; ② Serum levels of CA50, Scc-Ag, Pro-GRP before treatment in the high staging lung cancer group and recurrence metastasis group were significantly higher than those in the low staging group, no recurrence transfer group and after treatment of these groups（P〈0.01）. ③ The serum levels of CA50, Scc-Ag and ProGRP were higher in lung adenocarcinoma, squamous cell carcinoma and small cell carcinoma respectively（P〈0.01）. ④ The sensitivity of serum CA50, Scc-Ag, ProGRP in the diagnosis of lung cancer was 48.41%, 52.37%, 46.83% respectively, specificity was 96.00%, 98.00%, 94.00% respectively, accuracy was 61.93%, 64.77%, 60.23% respectively.The specificity of combined detection of three tumor markers for diagnosis of lung cancer was 86%, although it decreased, but the sensitivity and accuracy were improved by 95.24% and 92.61% respectively, compared with the individual items and two groups of two combination detection, the difference was significant （P〈0.01）.Conclusions Serum tumor markers CA50, Scc-Ag and ProGRP can be used as biological markers in the diagnosis of lung cancer, the sensitivity and accuracy of combined detection are obviously improved, which is helpful for early diagnosis, at the same time, combined dynamic detection can help to judge clinical staging, histological type, recurrence metastasis, monitoring prognosis and guiding treatment.