六项肿瘤标志物RIA诊断肺癌的临床价值探讨  

Study on the Clinical Value of Combined Determination of Six Tumor Marker for Diagnosis of Pulmonary Carcinoma

作　　者：陈忠[1] 刘云[1] 刘莉[1] 陆小鹏[1] 张军[1] 李建刚[1] 朱自力[1] 

机构地区：[1]江苏省南通市肿瘤医院核医学科,226361

出　　处：《放射免疫学杂志》2006年第4期305-306,共2页Journal of Radioimmanology

摘　　要：目的：本文选用CEA、CA125、CA50、CA19-9、CA153、CYFRA21-1等6种肿瘤标志物，探讨单项及组合检测对肺癌诊断的临床价值。方法：采用RIA法。结果：0340例肺良性疾病中仅CA125及CA153两组各发现1例阳性，与相应肺癌组经统计学处理呈显著性差异（P〈0．001）。②肺癌组单项检测阳性率以CYFRA21-1最高达79．23％，最低为CA50为43．84％，依次为CYFRA21-1（79．23％）〉CA153（61．53％）〉CA125（58．46％）〉CA19-9（57．69％）〉CEA（46．92％）〉CA50（43．84％）。③6种肿瘤标志物检测以CYFRA21-1为主，组合其它5项之一联合检测均可使单项组合检测阳性率分别提高到86．15％～89．23％。④良、恶性肺疾病患者组6项检测均值对比，肺癌组均值高于良性疾病组4倍以上。表明其对肺癌诊断的可信度较大。⑤本文对组织学分类确诊的108例鳞、腺癌分析，除CA199鳞、腺癌阳性率经统计学处理具显著性差异（P〈0．001）外，其余组间未见差异。结论：笔者认为，6种肿瘤标志物对肺癌诊断均有一定的临床价值，单项以CYFRA21-1为首选，组合检测以CYFRA21-1＋CA153或CA125／CA19-9为佳。Objective To study the clinical applicability of single/combined determination of six tumor markers （CEA, CA125, CA50, CA19 - 9, CA153, CYFRA21 - 1 ） for diagnosis of pulmonary carcinoma. Methods Serum contents of these six tumor markers were determined with RIA in 130 patients with pulmonary carcinoma, 40 patients with various benign pulmonary disorders, and 45 controls. Results ① Only two false positive eases were found in the 40 patients with benign pulmonary disorders （ CA125, n = 1, CA153 n = 1 ）. ② Positive rate of single marker in patients with pulmonary cancer： CYFRA21 - 1 （79.23%） 〉 CA153 （61.53%） 〉 CA125 （58.46%） 〉 CA19 - 9 （57.69%） 〉 CEA （46.92%） 〉 CA50 （43.84%）. ③ Combined determination of CYFRA21 - 1 with any one of the other 5 markers would increase the positive rate to 86.15%～ 89.23%. ④Mean value of any marker in the malignant eases were over 4 folds of that in the benign eases high diagnostic credibility. ⑤ Histology of the malignancy （ squamous cell carcinoma or adenocareinoma） made no differenee on the positive rate of the markers with the exception of a slight higher positive rate of CA19 -9 in adenocareinomas. Conclusion The authors believe that combined determination of CYFRA21 - 1 with CA153 would be the first choice for diagnosis of pulmonary carcinoma, followed by CYFRA21 -1 ＋ CA125 or CA19 -9.

关 键 词：肺癌 肿瘤标志物 放射免疫分析 

分 类 号：R734.2[医药卫生—肿瘤] R446.6[医药卫生—临床医学]