组织多肽特异性抗原细胞角蛋白19和癌胚抗原联合检测在肺癌诊断中的临床意义  

Clinical Significance of The Tissue Polypeptide-specific Antigen(TPS),Cytokeratin 19 Fragment Marker (CYFRA21-1) and Carcinoembryonic Antigen (CEA) in The Diagnosis of Lung Cancer

作　　者：李文新[1] 博晓真[2] 张军力[3] 成绥生[1] 贾向东[1] 

机构地区：[1]内蒙古自治区医院肿瘤科,内蒙古呼和浩特010017 [2]内蒙古医学院免疫教研室,内蒙古呼和浩特010059 [3]内蒙古医学院附属医院检验科,内蒙古呼和浩特010050

出　　处：《内蒙古医学杂志》2005年第2期103-106,共4页Inner Mongolia Medical Journal

摘　　要：目的 :评价组织多肽特异性抗原 (TPS)、CYFRA2 1- 1和癌胚抗原 (CEA)在各种病理类型肺癌中诊断的应用价值 ,通过联检观察它们在肺癌诊断中的敏感性和有效性。方法 :收集血清标本 12 7例 ,其中肺鳞癌 2 2例 ,腺癌 19例 ,小细胞肺癌 16例 ,不能分型肺癌组 13例 ,肺部良性疾病组 2 7例和正常对照 30例。采用酶联免疫吸附试验进行检测。结果 :TPS、CYFRA2 1- 1和CEA在肺癌各病理类型组的血清水平与正常对照组有差异 (P <0. 0 5 ) ,TPS和CEA在肺癌各病理类型组的血清水平高于良性病变组 (P <0 . 0 5 ) ,CYFRA2 1- 1在肺癌各病理类型组的血清含量与肺癌良性疾病组无差异 (P >0 . 0 5 )。TPS在肺癌组的灵敏度最高 ,为 85. 7% ,在肺部良性病变组的灵敏度为 2 9. 6 % ,TPS在肺癌各病理类型组的灵敏度无差异(P >0 .0 5 ) ,其特异性为 78 9%。CYFRA2 1- 1和CEA在肺癌的灵敏度分别为 2 7 .1%和 2 2 8% ,CYFRA2 1- 1在肺鳞癌中灵敏度最高 36 . 4 % ,CEA在肺腺癌中最高为 31 .6 %。TPS、NSE ,CYFRA2 1- 1和CEA三项联检 ,可明显提高肺癌诊断的灵敏度 ,但同时特异性有所下降。结论 :TPS在肺癌诊断上灵敏度较高 ,但特异性较差 ,不宜单独用于肺癌诊断。CYFRA2 1- 1和CEA在肺癌诊断上灵敏度较低 ,但特异性强 ,在肺癌诊?Objective:To evaluate the clinical value of TPS,CYFRA21-1 and CEA in the diagnosis of varied groups of lung cancer.To observe the sensitivity and accuracy by combined detection of three tumor markers.Methods:The serum samples of 127 patients were measured:including 22 squamous cell carcinomas,19 adenocarcinomas ,16 small-cell cancers,13 unclassified lung cancers,27 benign pulmonary diseases and 30 normal control groups.Serum was e dtected by ELISA.Results:There was a difference in serum level of TPS,CYFRA21-1 and CEA(P<0 05) between lung cancer groups and control groups.The serum level of TPS and SCLC is higher in lung cancer group(P<0 05) than that in benign group.There was no difference(P>0 05)in the serum level of CYFRA21-1between lung cancer groups and benign group.The sensitivity of TPS of 85.7% in lung cancer groups is the highest and it is 29.6% in benign groups and the specificity is 78.9%.There was no difference in sensitivity of TPS in varied lung cancer groups(P>0 05).The sensitivity of CYFRA21-1 and CEA is,respectively 27.1% and 22.8%.CYFRA21-1 shwed the highest sensitivity (36.4%) in squamous cell carcionmas,CEA highest in adenocarcinomas (31.6%).The combined detection of three tumor markers may improve the sensitivity for lung cancer detection,but specificity declines.Conclusion:Being the tumor markers with high specificity and sensitivity,TPS has a higher sensitivity in the detection of lung cancer but shows low specificity,thus can not be used alone in the detection of lung cancer.CYFR21-1 and CEA has a lower sensitivity but high specificity,thus shows some clinical value.The combined detection of three tumor markers can increase diagnosis rate of lung cancer,which shows some clinical value.

关 键 词：肺癌 标志物 TPS CYFRA21—1 CEA 肺癌诊断 

分 类 号：R446.62[医药卫生—诊断学] R734.2[医药卫生—临床医学]