血清CEA和CA199在肺部疾病诊断中的临床评价  

Clinical evaluation of serum CEA and CA199 for pulmonary diseases.

作　　者：杨中华[1] 左永太[1] 

机构地区：[1]四川大学华西医院老年科实验医学科,四川成都610041

出　　处：《四川医学》2008年第6期652-654,共3页Sichuan Medical Journal

摘　　要：目的运用临床流行病学理论全面分析与评价血清CEA及CA199对肺癌的诊断效率和临床意义。方法应用电化学发光免疫分析法检测212例肺癌,35例肺结核,50例肺炎,20例支气管炎患者血清CEA及CA199水平,对其敏感性,特异性,准确性,阳性预测值,阳性似然比及优势比进行比较,并分析二者在肺癌中的相关性。结果CEA和CA199诊断肺癌的敏感性分别为64.2%和54.2%,特异性74.3%和88.6%,阳性预测值83.4%和90.6%,阳性似然比2.5和4.7,优势比为5.2和9.2;CEA和CA199两者之一为阳性的敏感性和特异性分别为75.9%及70.5%,阳性预测值、阳性似然比及优势比分别为83.9%,2.6及7.5;两者均阳性时,敏感性降为42.5%;特异性为88.6%,并且CEA与CA199在肺癌诊断中具有显著相关性(r=0.38,P<0.05)。结论联合检测CEA及CA199能提高肺癌诊断的敏感性和准确性,具有重要的临床提示价值和筛查意义。Objective To apply the clinical epidemic principles to analyzed and evaluate the diagnostic value and clinical signiflcancc of such tumor markers as CEA and CA199 in lung cancers .Methods The serum concentrations of these tumor markers in patients with 212 lung cancers, 35 pulmonary tuberculosis,50 pneumonia and 20 bronchitis by means of electroehemiluminescence immunoassay （ECLIA） were detected and their sensivitity, specificity, accuracy, positive predictive value （ PPV ）, positive likelihood ratio （ LR ＋ ） and odds ratio（OR） were compared and then their association was analyzed .Results The sensitivity of CEA and CA199 to diagnose lung cancers was 64.2% and 54.2% respectively ,while the specificity of them was 74.3% nd 88.6% ,respectively. Besides, PPVs were 83.4% and 90.6% for CEA and CA199 to diagnose the tumors. LR ＋ s were 2.5 and 4.7 .ORs were 5.2 and 9.2.The sensitivity, specificity,PPV,LR ＋ and OR were 75.9% ,70.5% ,83.9% ,2.6 and 7.5 respectively as long as one of them was positive.The sensitivity was 42.5 % and specificity was 88.6 % if both were positive. Furthermore, CEA and CA199 showed a chlose association in lung cancer diagnosis （ r =0. 38, P 〈 0. 05 ）. Conclusion The detection of CEA and CA199 in combination would help to improve the sensivitity and accuracy in diagnosis of lung cancers, showing its important indicative value for clinic.

关 键 词：癌胚抗原 CA199 电化学发光免疫分析 诊断评价 

分 类 号：R446.6[医药卫生—诊断学]