肺癌胸腔积液CEA和CYFRA21-1及NSE术中联检的临床价值  

Clinical value of combined detections of intraoperative pleural effusion CEA, CYFRA21-1 and NSE in lung cancer

作　　者：臧琦[1] 蒋仲敏[1] 王伟[1] 杨宜娥[2] 朱强[1] 王连生[1] 

机构地区：[1]山东省千佛山医院胸外科,山东济南250014 [2]山东省千佛山医院放免室,山东济南250014

出　　处：《中华肿瘤防治杂志》2006年第17期1310-1312,共3页Chinese Journal of Cancer Prevention and Treatment

基　　金：山东省自然科学基金(2004ZX10)

摘　　要：目的：探讨术中胸液CEA、CYFRA21—1和NSE联栓对肺癌患者预测胸膜微转移的价值。方法：术中采集35例肺癌患者和20例良性肺疾病患者的胸腔积液，应用电化学发光免疫分析（ECLIA）技术，进行CEA、CYFRA21—1和NSE联栓。结果：肺癌组CEA、CYFRA21—1和NSE水平分别为（144．81±272．56）、（252．20±171．91）和（107．30±88．53）μg／L，明显高于良性疾病组的（1．94±3．72）、（45．46士34．74）和（43．66±29．88）μg／L，t值分别为-2．335、-5．296和-3．105，P值分别为0．023、0．000和0．003。分别以〉8、102和92μg／L为阳性界值，以其中两项或三项阳性为诊断依据，对胸膜微转移有较高的诊断灵敏度（74．3％）和特异度（100％）；随访1～12个月，已有5例患者术后出现癌性胸腔积液，其中腺癌4例，鳞状细胞癌1例。结论：初步断定此方法对胸膜微转移有重要的预测价值，其中对肺腺癌患者价值更大。OBJECTIVE： To discuss the value of combin detections of intraoperative pleural effusion CEA, CYFRA21-1 and NSE for forecasting pleural micrometastasis in lung cancer. METHODS： The intraoperatire pleural effusion from 35 malignant pulmonary cases and 20 benign pulmonary caseswas collected, then the pleural effusion CEA, CYFRA21-1 and NSE were analyzed by ECLIA. RESULTS： The levels of CEA, CYFRA21-1 and NSE in patients with lung cancer were signif- icantly higher than those in patients with benign lung disease [（ 144. 81±272.56） and （1.94±3.72）μg/L, t=-2.335, P=0.023; （252.20±171.91） and （45.46±34.74）μg/L, t=-5.296,P= 0.000; （107.30±88.53） and （43.66±29.88）μg/L, t=-3.105, P=0. 003], respectively. The cutoff limits were bigger than 8μg/L, 102 μg/L and 92μg/L, respectively; and 2 or 3 of those positive figures could be regarded as the diagnostic evidence. This method had high sensitivity （74.3%） and specificity （100% ） for the diagnosis of pleural micrometastasis. After 1 to 12 months follow up, there were 5 cases suffered malignant pleural effusion postoperation, including 4 adenocarcinoma and 1 squamous cell carcinoma cases. CONCLUSIONS： The method of combined defection of intraoperative plearal effnsion CEA, CYFRA21-1 and NSE contributes to forecast pleural micrometastasis, especially to the pulmonary adenocarcinoma after operation.

关 键 词：肺肿瘤/外科学 胸腔积液 恶性/诊断 癌胚抗原/分析 抗原 肿瘤/分析 肿瘤标记 生物学 

分 类 号：R734.2[医药卫生—肿瘤]