细胞角蛋白片段19和其他生化指标的检测在肺癌诊断中的应用

Application of the detection of CK-19 and other assiociated biochemistry items in the diagnosis of lung cancer

目的 探讨胸水和血清细胞角蛋白片段 19(cytokeratin 19fragment,CK 19)和其它生化指标的检测在肺癌特异性实验室诊断中的临床意义。方法 采用ELISA法检测 4 5例临床确诊的各种肺癌患者、5 0例非肿瘤性肺及支气管疾病患者血清和胸水中CK 19水平 ,30例健康体检者血清CK 19水平 ,同时采用本室常规方法测定了以上患者血清及胸水和健康对照组血清中乳酸脱氢酶 (lactatedehydrogenase ,LDH)及其同功酶 (LD 1)、腺苷脱氨酶 (adenosinedeaminase ,ADA)、C反应蛋白 (C responseprotein ,CRP)、癌胚抗原 (carcinoembryonicantigen ,CEA)、免疫球蛋白E(immunoglobulinE ,IgE)和白蛋白 (albumin ,ALB)水平 ,并进行相关性分析。结果 肺癌患者血清和胸水中CK 19、CEA、LDH和LD 1水平均明显高于非癌性肺疾病患者和正常健康对照组 (P <0 0 5 ) ,而ADA水平均低于非癌性肺疾病患者和健康对照组 (P<0 0 5 )。非癌性肺疾病患者血清和胸水CRP水平明显高于肺癌组和健康对照组 (P <0 0 5 )。相关性分析显示 ,胸水中CK 19水平与血清CK 19水平高度相关 (r=0 86 8,肺癌组 ;r =0 5 4 6 2 ,非癌性肺疾病组 )。胸水和血清CK 19对肺癌的诊断敏感性、特异性和准确性分别为 93 3%和 71 1%、91 7%和 87 5 %、92 %和 81 6 %。

Objective To detect cytokeratin 19 fragment (CK-19) and other associated biochemical items and analysis their clinical significance for specific diagnosis of the lung cancer in the laboratory.Methods the level of CK-19 in the PE and serum of 45 lung cancer patients, 50 non-cancer lung and bronchus disease patients, and the level of CK-19 in the serum of 30 healthy people control were detected by ELISA, and the correlation of these parameters was analysised. Other associated biochemical items including lactate dehydrogenase(LDH), isoenzymes of lactate dehydrogenase(LD-1), adenosine deaminase(ADA), C-response protein(CRP), carcinoembryonic antigen(CEA), immunoglobulin E(IgE), and albumin(ALB) were assayed in the PE and serum of these patients.Results The level of CK-19, CEA, LDH, and LD-1 in lung cancer group were higher than in non-cancer lung and bronchus disease group and healthy people control group( P <0 05), but the level of ADA in lung cancer group were lower than in non-cancer lung and bronchus disease group and healthy people control group( P <0 05). The level of CRP was increased significantly in the non-cancer lung and bronchus disease group( P <0 05). The level of CK-19 in the PE were significantly correlated with that in the serum of patients with lung cancer ( r =0 868) and patients with non-cancer lung and bronchus disease( r =0 5462). The sensitivity, specificity, and accuracy of CK-19 in the PE and serum as a diagnostic test for lung cancer were 93 3%, 71 1%, 91 7% and 87 5%, 92%, 81 6% respectively. Conclusion Pleural effusion CK-19 may be a useful test for diagnosing lung cancer. It may be more benificial for diagnosing lung cancer measuring the CK-19 and other associated biochemical items combinatorial optimation.