四种肿瘤标志检测非小细胞肺癌的临床应用研究

To investigate the clinical value of four tumor markers in non-small cell lung cancer

目的 研究与非小细胞肺癌 (NSCLC)相关的血清癌胚抗原 (CEA )、细胞角蛋白片断2 1 1(CYFRA2 1 1)、组织多肽特异性抗原 (TPS)和鳞状上皮细胞癌抗原 (SCC)等 4种肿瘤标志的临床应用价值。方法 采用电化学发光免疫分析仪 (Elecsys 2 0 10 ) ,快速微粒子酶免疫分析仪 (IMx) ,酶联免疫吸附法分别检测 76例NSCLC患者 ,13例肺良性疾病患者及 3 6名健康成人血清中的CEA、CYFRA2 1 1、TPS和SCC ,并对 2 7例NSCLC术后 1个月的患者进行随访检测。同时用SPSS10 0统计软件及接受器工作性能曲线 (ROC)分析 ,评价肿瘤标志物的临床应用价值。结果 血清CEA、CYFRA2 1 1和TPS水平随临床分期 (TNM )增加而升高 ,与正常人比较差异有显著性 (P <0 0 1) ,对于评价NSCLC具有一定的临床参考价值。各种组合检测中 ,以CEA +CYRA2 1 1+TPS组敏感性和有效性最高。手术治疗后 ,4种肿瘤标志均较术前明显下降。SCC仅对于肺鳞癌与腺癌的鉴别具有一定的参考价值。结论 4种肿瘤标志物在NSCLC诊断治疗中 ,具有一定的临床应用价值。CEA +CYFRA2 1

Objectives To investigate the clinical value of the serum levels of Carcinoembryonic antigen(CEA), Cytokeratin-19-fragments(CYFRA21-1),Tissue Polypeptide Specific Antigen(TPS) and Squamous. Cell Carcinoma Antigen(SCC) in patients with Non-Small Cell Lung Cancer(NSCLC).Methods CEA and CYFRA21-1 were measured by an electrochemiluminescence method with the use of ELECSYS 2010 analyzers. SCC was measured imunoenzymatically, with MEIA methods, using IMx analyzers. TPS was determined by Enzyme-Linked Immunosorbent Assay. 36 Healthy adults and 13 benign pulmonary diseases and 76 patients with non-small cell lung cancer were detected. All data were analyzed by SPSS 10 0 and Receiver Operating Characteristic Curve(ROC). Results The value of CEA,CYFRA21-1 and TPS in the NSCLC,it changed in relationship to stage of disease. There was a significant reference (P<0 05) from normal control values. There was a useful clinical reference value to evaluate NSCLC. The sensitivity and effectiveness of the group of CEA+CYFRA21-1+TPS was highest in nine-combined groups. After operation, a marked decrease in these values were observed. It may be used for assessing curative effect after-operation. The level of SCC was demonstrated higher value in squamous cell carcinomas only. Conclusions There was specifically clinical application value of these four tumor markers for diagnosis and cure of NSCLC. The sensitivity and utility can be increased with combination of CEA+CYFRA21-1+TPS in diagnosis of NSCLC.