非小细胞肺癌患者呼出气冷凝液中CEA检测的临床意义  

Clinical significance of measuring the CEA in exhaled breath condensate of patients with non-small cell lung cancer

作　　者：董敬军[1] 陶一江[1] 陈建荣[1] 蔡映云[2] 陶国华[1] 

机构地区：[1]南通大学第二附属医院呼吸科,226001 [2]复旦大学附属中山医院呼吸病研究所,200032

出　　处：《临床肺科杂志》2008年第7期828-830,共3页Journal of Clinical Pulmonary Medicine

基　　金：江苏省"六大人才高峰"资助课题(06-B-18);南通市科委社会发展计划项目(S2006048)

摘　　要：目的研究非小细胞肺癌(NSCLC)患者呼出气冷凝液(EBC)中癌胚抗原(CEA)检测的临床意义。方法采用德国JAEGER公司的EBC收集器,收集NSCLC组和正常对照组的EBC,所有对象同时抽血留血清待测。采用非平衡放射免疫分析法(RIA)测定EBC和血清中CEA。结果①肺癌组CEA检测值,EBC为4.52±2.44mg/L,血清为7.73±3.19mg/L;正常对照组CEA检测值,EBC为1.62±1.30mg/L,血清为2.28±1.30mg/L,两组比较有显著统计学意义(P<0.01);②腺癌组EBC和血清标本中CEA水平分别为(4.91±2.56mg/L)和(9.17±3.75mg/L),高于正常对照组(P<0.05);③Ⅰ期、Ⅱ期、Ⅲ期和Ⅳ期NSCLC患者EBC中CEA水平分别为3.32±1.58mg/L、4.11±2.45mg/L、4.75±2.50mg/L、5.48±2.41mg/L,TNM分期越高,EBC中CEA的水平越高,F=3.12,P<0.05;④肺癌组EBC和血清CEA检测值呈线性正相关,回归方程=1.61x-1.51,相关系数(r)=0.8615,P<0.05;⑤肺癌组EBC中CEA检测的敏感性和特异性为51.5%和93.3%,血清中为60.6%和91.1%。肺癌组同时进行EBC和血清中CEA检测,联合敏感性为80.9%,联合特异性85.0%。结论在EBC中检测CEA水平有助于肺癌的早期诊断和临床分期的判断。Objective To investigate the clinical significance of measuring the CEA in exhaled breath condensate （EBC） in diagnosis and treatment of Non-Small Cell Lung Cancer （NSCLC）. Methods EBC of patients with NSCLC and the control group were collected with the special collector from JAEGER company in German, and serum samples of two groups were collected as well. CEA was determined with non-equilibrium radioimmunoassay method. According to the standard of means adding double standard difference, the normal reference value of CEA was not more than 5mg/L in serum, and not more than 4mg/L in EBC. Results ①The values of CEA in EBC and serum in NSCLC group were 4. 52 ±2. 44 mg/L and 7.73±3. 19 mg/L, and those in the control group were 1.62 ± 1.30 mg/ L and 2. 28 ± 1.30 mg/L （ P 〈 0. 01 ）. ②The CEA values in EBC and serum of patients with adenocareinoma were 4. 91 ± 2. 56 mg/L and 9. 17±3.75 rag/L, higher than those in the control group （ P 〈 0. 05 ）. ③The values of CEA in Ⅰ, Ⅱ , Ⅲ and Ⅳ stages of the NSCLC group were 3.32 ± 1.58 mg/L, 4. 11 ± 2. 45 mg/L, 4. 75 ± 2. 50 mg/L and 5. 48 ± 2. 41 mg/L in EBC. The higher the TMN stage, the higher the value of CEA in EBC （ F = 3. 12, P 〈 0.05 ）. ④The relation of CEA between EBC and serum was linear positive correlation （ Y = 1.61 x - 1.51, r = 0. 8615, P 〈 0. 05 ）. ⑤The sensitivity and specificity of CEA examination in EBC of the NSC LC group were 51.5% and 93.3%, and those in serum were 60. 6% and 91. 1%. CEA in EBC and serum of the NSCLC group was determined at the same time, the combine sensitivity and specificity of CEA examination were 80. 9% and 85.0%. Conclusion Investigation of CEA in EBC was particularly helpful to early diagnosis of lung cancer and judgment of the TMN stages of NSCLC.

关 键 词：癌胚抗原 呼出气冷凝液 非小细胞肺癌 

分 类 号：R734.2[医药卫生—肿瘤]