溶血对肿瘤标志物检验准确性的影响及改进方法

Effect of Hemolysis on the accuracy of tumor markers and its improvement method

目的:探讨溶血对肿瘤标志物检验准确性的影响,并寻找改进方法。方法:选取2017年1月-2018年10月在广州市增城区人民医院体检接受肿瘤标记物检测的受试者共132例纳入本次研究。所有受试者空腹抽取静脉血,分置于两个采血管内,其中一个采血管经高速离心后收集上层血清,纳入非溶血组;而另一根采血管纳入溶血组,用竹签搅拌捣烂,经离心后制成溶血血清标本。采用全自动电化学发光免疫分析仪检测肿瘤指标,并比较非溶血组和溶血组样本中肿瘤标志物糖类抗原125(Carbohydrate Antigen 125,CA125)、糖类抗原15-3(Carbohydrate Antigen 15-3,CA15-3)、糖类抗原19-9(Carbohydrate Antigen19-9,CA19-9)、癌胚抗原(Carcino-embryonic Antigen,CEA)以及神经元特异性烯醇化酶(Neuron Speci?c Enolase,NSE)的表达水平。结果:两组样本比较,CA125(t=1.684,P=0.094)、CA15-3(t=1.216,P=0.226)、CA19-9(t=1.137,P=0.258)和CEA(t=0.982,P=0.328)的差异无统计学意义。但非溶血组的NSE水平显著低于溶血组,差异有统计学意义(t=11.348,P=0.000)。结论:溶血对血液标本中NSE的检测结果产生巨大的影响,但对其他肿瘤标志物的检测影响较少。临床上可根据标本检测项目的不同,选择不同的处理溶血标本的方法。

Objective:To explore the effect of hemolysis on the accuracy of tumor marker test and to seek for improvement methods.Methods:A total of 132 subjects who underwent tumor marker examination in Guangzhou Zengcheng District People's Hospital from January 2017 to October 2018 were selected to be included in this study.Venous blood was extracted on an empty stomach and placed in two blood collection tubes,one of which collected upper serum after high-speed centrifugation and was included in the non-hemolytic group.The other blood vessel was included into the hemolytic group,stirred and mashed with a bamboo stick,and centrifuged to make a hemolytic serum specimen.Tumor indicators were detected by automatic electrochemical luminescence immune analyzer,and the expression levels of tumor markers CA125,CA15-3,CA19-9,CEA and NSE in samples from the non-hemolytic group and the hemolytic group were compared.Results:The differences of CA125(t=1.684,P=0.094),CA15-3(t=1.216,P=0.226),CA19-9(t=1.137,P=0.258)and CEA(t=0.982,P=0.328)were not statistically significant.However,the NSE level of the non-hemolytic group was significantly lower than that of the hemolytic group,with a statistically significant difference(t=11.348,P=0.000).Conclusion:Hemolysis has a significant effect on the detection results of NSE in blood samples,but it has less effect on the detection of other tumor markers.Clinically,different methods of hemolysis can be selected according to different specimen detection items.