肿瘤标志物NSE TPSC YFRA21-1联合检测肺癌  

Combined Assays of Neurone Specific Enolase,Tissue Polypeptide Specific Antigen and Cytokeratin 19 Fragment Marker in Lung Cancer

作　　者：李文新[1] 成绥生[1] 刘阿秋[1] 张翠英[1] 贾向东[1] 李智军[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

出　　处：《内蒙古医学杂志》2005年第4期289-292,共4页Inner Mongolia Medical Journal

摘　　要：目的:评价神经元特异性烯醇化酶(NSE)、组织特异性抗原(TPS)和细胞角蛋白19片段(CYFRA 2 1- 1)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准确性。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例和正常对照组30例。采用酶联免疫吸附试验进行检测。结果:TPS、NSE和CYFRA 2 1- 1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 ) ,NSE和TPS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 ) ,CYFRA 2 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 )。NSE在小细胞肺癌组的血清水平与肺部良性病变组和正常对照组有显著性差异(P <0 . 0 1) ,NSE在小细胞肺癌组的敏感性为75 % ,与肺腺癌组比较有差异(P <0 .0 5 ) ,特异性为96 . 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%。CYFRA 2 1- 1在肺癌的灵敏度分别为2 7. 1% ,CYFRA 2 1- 1在肺鳞癌中灵敏度最高,36. 4 %。TPS、NSE和CYFRA 2 1- 1三项联检,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:Objective:To evaluate the clinical value ,s ensitivity and specificity of neurone specific enolase (NSE),tissue polypeptide specific antigen (TPS) and cytokeratin 19 fragment marker (CYFRA 21-1) in the pa t hological diagnosis of lung cancers.Methods:127 serum specimens were collected and detected by enzyme-linked immunosorbent assay.Of 127 cases,2 2 was squamous cell carcinoma,19 adenocarcinoma,16 small-cell lung cancer,13 unid entified lung cancer,27 benign pulmonary diseases and 30 normals.Results :There was difference in levels of NSE,TPS and CYFRA 21-1 between lung c a ncer group and control group (P<0.05).The level of NSE and TPS was higher in lung cancer group than that in benign group (P<0.05) .There was no difference in the level of CYFRA 21-1 between lung cancer gr o up and benign group (P>0.05).The sensitivity of NSE in small-c ell lung cancer group was 85%,showing difference from that in adenocarcinoma gro up (P<0.05).The sensitivity of TPS in cancer and benign group was respectively 75.7% and 29.6%,which was highest in lung cancer group.There wa s no differences among cancer groups (P>0.05).The sensitivity of CYFRA 21-1 was 27.1% in cancer groups,highest (36.4%) in squamous cell carcin oma group.The specificity of NSE and TPS was 96.5% and 78.9%,respectively.Combi ned assays of TPS、NSE and CYFRA 21-1 increased the sensitivity,but decreased th e specificity in diagnosis of lung cancer.Conclusion:NSE is an import ant marker with high sensitivity and specificity,specially for small-cell lung c ancer.TPS with lower specificity should not be applied singly in diagnosis of lu ng cancer.CYFRA 21-1 has certain value in diagnosis of lung cencer,for higher sp e cificity.Simultaneous detection of NSE,TPS and CYFRA 21-1 can notably improve th e sensitivity and specificity of diagosis in lung cancer.

关 键 词：肺癌 标志物 组织特异性抗原 神经元特异性烯醇化酶 细胞角蛋白19片段 诊断 

分 类 号：R734.2[医药卫生—肿瘤] R730.45[医药卫生—临床医学]