多种肿瘤标志物蛋白芯片检测系统对肺癌的诊断价值

Diagnostic value of multiple tumor marker protein biochip detective system for lung cancer

目的 研究多种肿瘤标志物蛋白芯片检测系统对肺癌的诊断价值。方法 用该检测系统测定10 8例肺癌患者、48例肺良性病变患者和 14 5例正常人血清中 12种肿瘤标志物 (CA199,NSE ,CEA ,CA2 42 ,CA12 5 ,CA15 3 ,AFP ,ferritin ,free PSA ,PSA ,β HCG及HGH)的水平。 结果 肺癌组的芯片阳性率为 83 .3 3 %( 90 / 10 8) ,显著高于肺良性病变组 ( 5 2 .0 8% ,2 5 / 48)和健康组 ( 2 8.97% ,42 / 14 5 ) (P <0 .0 0 1) ;肺癌不同分期组间阳性率存在显著性差异 ,以Ⅳ期肺癌组阳性率最高 (P =0 .0 48) ,但不同病理类型肺癌组间无显著性差异(P =0 .5 19) ;不同分期之间CA199、CEA以及CA2 42血清水平存在显著性差异 (P =0 .0 41,P =0 .0 18和P =0 .0 0 2 ) ;CEA阳性率以腺癌组最高 ,与其它组织学类型肺癌比较无显著性差异 (P =0 .0 7) ;NSE阳性率以小细胞肺癌组最高 (P <0 .0 0 1) ;联合检测在提高诊断敏感性的同时 (P <0 .0 0 1) ,特异性有所下降 (P <0 .0 0 1)。结论 运用蛋白芯片联合检测多种血清肿瘤标志物可明显提高肺癌诊断的敏感性 ,同时对于确定其临床分期 ,鉴别病理类型以及监测疗效均有一定的意义。由于该法特异性及阳性预测值偏低 ,更适合于无明显症状的门诊患者和肺癌高危人群的筛查。

Objective To evaluate the diagnostic values of multiple tumor marker protein biochip detective system for lung cancer. Methods The serum levels of 12 tumor markers, including CA199, NSE, CEA, CA242, CA125, CA153, AFP, ferritin, free-PSA, PSA, β-HCG and HGH, were measured in 108 lung cancer patients, 48 patients with benign pulmonary lesion and 145 healthy by the detective system. Results The positive rates were 83.33% (90/108), 52.08% (25/48) and 28.97% (42/145) in lung cancer, benign pulmonary lesion and healthy groups, respectively. The lung cancer group had significantly higher positive rate than that of the controls (χ 2=16.75 and 73.32, both P<0.001); There was significant difference of positive rate in various clinical stages of lung cancer (χ 2=7.89, P=0.048), but not in different pathologic classification. Serum CA199, CEA and CA242 levels were closely correlated with clinical staging (F=2.84, P=0.041; F= 3.49, P=0.018; F =5.22, P=0.002). The positive rate of CEA in adenocarcinoma was higher, but no significant difference was observed (χ 2=0.71, P=0.07). NSE in small cell lung cancer had the highest positive rate (χ 2=19.03, P<0.001). Combined measurement of the twelve markers had higher sensitivity (χ 2= 368.58, P<0.001), but less specificity (χ 2= 369.87, P<0.001). Conclusion Combined measurement of various serum tumor markers using protein biochip can significantly increase the diagnostic sensitivity for lung cancer. Meanwhile, it is also significant for defining clinical stage, identificating pathologic classification, as well as monitoring therapeutic efficacy. As its specificity and positive predictive value are lower, it is more suitable to be used as a surveying tool for symptomless people, especially for high risk people for lung cancer.