用积分法评价7项血清肿瘤标志物对非小细胞肺癌的诊断价值  

The value of integral method with the seven tumor markers in the diagnosis of non-small cell lung cancer

作　　者：周永列[1] 邵浙新[2] 敖建云[3] 应奇峰[1] 陈永健[1] 皇甫梅生[1] 刘建栋[2] 

机构地区：[1]浙江省人民医院检验医学中心,浙江杭州310014 [2]浙江大学医学院附属第一医院 [3]江苏大学医学技术学院

出　　处：《中国实验诊断学》2007年第12期1628-1631,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探讨用积分法评价血清细胞角蛋白片段21-1(CYFRA21-1)、癌胚抗原(CEA)、组织多肽特异性抗原(TPS)、糖类抗原CA125、CA153、CA199、和铁蛋白(FER)等7项肿瘤标志物对非小细胞肺癌(NSCLC)的诊断价值。方法采用免疫化学发光法、增强化学发光酶联免疫分析法和免疫放射分析法分别检测70例NSCLC患者、53例肺部良性疾病和72名正常对照者血清中的CYFRA21-1、CEA、TPS、CA125、CA153、CA199、FER,根据这些肿瘤标志物单项诊断NSCLC的有效性分别积分为4、3、32、、21、、1分,计算总积分。用总积分评价7项肿瘤标志物对NSCLC诊断的临床应用价值,并与NSCLC的TNM分期进行相关性分析和组织学分型比较。结果单项指标诊断NSCLC的灵敏度在32.9%-65.7%间,特异性在64.0%-96.8%,有效性在62.1%-85.1%间,积分法诊断NSCLC的灵敏度为82.8%,特异性为96.8%,诊断有效性91.8%。总积分水平与NSCLC患者的TNM分期呈显著正相关(r=0.68,P<0.001)。结论在对NSCLC患者用CYFRA21-1、CEA、TPS、CA125、CA153、CA153、和FER进行组合检查时,用积分法评价可显著提高对NSCLC的诊断价值。Objective To evaluate the clinical value of integral method with Cytokeratin-19-fragment（CYFRA21-1）, Carcinoembryonic antigen（CEA）, Tissue polypeptide specific antigen（TPS）, CA 125, CA153, CA153, Ferritin（FER） in the diagnosis of non-small cell lung cancer （NSCLC）. Methods CA125, CA153, CA199, CEA and FER were measured by chemiluminescence immunoassay with the use of ACS： 180 analyzer, rlPS was detected by enhanced chemiluminescence immunoassay with IMMULITE analyzer. CYFRA21-1 was determined by immunoradiometric assay.70 patiants with non-small cell lung cancer 53 with benign pulmonary diseases and 72 Healthy adults were studied.CYFRA21-1 ,CEA,TPS,CA125,CA153,CA199,FER were integrated 4,3,3,2,2,1,1 respectively according the utility of single tumor marker in the diagnosis of NSCLC. The clinical diagnosis value was evaluated by integral method. Rank correlation analysis was used to assess the relation between value of integration and TNM stage. Results The sensitivity of single tumor maker in the diagnosis of NSCLC was between 32.9% - 65.7;their specificity was between 64.0% - 96.8% ;the diagnostic utility was between 62.1% - 85.1% ;In the integrated method,the sensitivity and specificity were 82.8% and 96.8% respectively;the utility was 91.8% in the diagnosis of NSCLC. The integral level of an seven tumor marker was correlated with TNM stage. Conclusion The utility can be increased with the integrated mthod of CYFRA21-1,CEA,CA125,CA153,CA199, FER in the diagnosis of NSCLC.

关 键 词：癌 非小细胞肺 积分法 肿瘤标志物 细胞角蛋白片段21-1 癌胚抗原 组织多肽特异性抗原 糖类抗原 125 糖类抗原153 糖类抗原199 铁蛋白 

分 类 号：R734.2[医药卫生—肿瘤]