血清癌胚抗原、CA125、CA19-9测定对肺癌诊断及预后判断的价值  

Diagnostic and Prognostic Values of Serum Carcinoembryonic Antigen, CA125 and CA19-9 Level in Patients with Lung Cancer

作　　者：蔡东焱[1] 陶敏[1] 段卫明[1] 王振欣[1] 谢菁[1] 冯军[1] 王庆才[1] 

机构地区：[1]苏州大学附属第一医院肿瘤科,江苏苏州215006

出　　处：《苏州大学学报（医学版）》2007年第4期558-561,565,共5页Suzhou University Journal of Medical Science

摘　　要：目的探讨血清癌胚抗原(CEA)、CA125、CA19-9测定对肺癌诊断和预后判断的价值。方法用化学发光免疫分析法测定118例肺癌患者血清CEA、CA125、CA19-9的水平,并进行分组分析,同时以100例健康体检者和11例肺良性疾病患者作为对照。结果肺癌患者血清CEA、CA125、CA19-9水平高于良性肺病患者和健康人,差异均有高度统计学意义(均P<0.01),且随着分期增加而逐渐升高,Ⅲ、Ⅳ期肺癌组显著高于Ⅰ、Ⅱ期肺癌组,差异有高度统计学意义(P<0.01)。以3种标志物正常值为标准,Ⅰ、Ⅱ期肺癌的诊断敏感性和特异性较低,Ⅲ、Ⅳ期肺癌则明显增高,三者联合检测可提高敏感性和特异性。化疗有效组治疗后CEA和CA125较治疗前明显下降,差异有统计学意义(P<0.05),化疗无效和稳定组化疗前后3种标志物水平无明显变化,差异无统计学意义(P>0.05)。结论血清CEA、CA125、CA19-9水平对肺癌的早期诊断价值不高,但对患者病情进展和预后判断有一定的意义;血清CEA和CA125水平的变化对晚期肺癌患者化疗效果的判断有一定价值。Objective To evaluate the diagnostic and prognostic values of serum carcinoembryonic antigen（CEA）, CA125 and CA19-9 level in patients with lung cancer. Methods Chemiluminesent immunoassay （CLIA） was used to detect the serum level of CEA, CA125 and CA199 in 118 patients with lung cancer, 100 health persons and 11 patients with benign pulmonary disease. Results Serum CEA, CA125 and CA19-9 level in patients with lung cancer was significantly higher than that in health persons and patients with benign pulmonary disease （P 〈 0.01 and 〈 0.01, respectively）. With the clinic stage variation, the serum level of the three markers were gradually raised in patients with lung cancer. The serum level of the three markers in patients with stage HI and IV lung cancer was significantly higher than that in patients with stage I and lI lung cancer （P〈O. 01 and 〈0.01, respectively）. Taking the normal values of the three markers as the standards, the diagnostic sensitivi- ties and specificities of the three serum markers were low in stage I and II patients, and obviously increased in patients in stage 111 and IV . Combining measurement of these serum markers could in- crease the diagnostic sensitivity and specificity for lung cancer. The serum level of CEA and CA125 was significantly lower after chemotherapy than that before chemotherapy in the patients with lung cancer responded to chemotherapy （P〈0.05）. However, in the patients with lung cancer failed to respond to chemotherapy the serum level of the three markers had no obvious changes before and after chemotherapy. Conclusion The serum level of CEA, CA125, and CA19-9 is not so useful in early diagnosis of lung cancer, but they have definite value for evaluation of the progress and prognosis of lung cancer. The changes of serum CEA and CA125 level is valuable to evaluate the effect of chemotherapy in patients with advanced lung cancer.

关 键 词：肺癌 癌胚抗原 CA125 CA199 诊断 

分 类 号：R734.204[医药卫生—肿瘤]