四项肿瘤标志联合检测在小细胞肺癌中的临床价值  

The clinical value of tissue polypeptide specific antigen, neuron-specific enolase, carcinoembryonic antigen and CA125 level in small cell lung cancer

作　　者：李学祥[1] 周善良 王憨杰[1] 韩彬彬[1] 齐军[1] 

机构地区：[1]中国医学科学院肿瘤医院检验科,北京100021 [2]山东省临沂市肿瘤医院

出　　处：《中华检验医学杂志》2008年第9期1011-1015,共5页Chinese Journal of Laboratory Medicine

基　　金：TerryFox基金资助项目（LC2007833）

摘　　要：目的探讨小细胞肺癌（SCLC）患者血清中组织多肽特异性抗原（TPS）、神经元特异烯醇化酶（NSE）、癌抗原125（CA125）和癌胚抗原（CEA）水平，对SCLC临床诊断、病情监测的临床意义。方法用ELISA法检测271例SCLC和80例肺良性疾病患者及224名健康对照者血清TPS水平；同时用电化学发光法检测血清NSE、CA125和CEA水平；并用约登指数和受试者工作特征曲线（ROC曲线）分析4项肿瘤标志及其各项肿瘤标志联合检测SCLC患者的效能。结果SCLC组的TPS、NSE、CA125和CEA血清水平明显高于肺良性疾病组和健康对照组（Z均〉1．90，P均〈0．01）；广泛期SCLC患者的血清TPS和NSE明显高于局限期患者（Z分别为2．69、2．27，P分别为0．009、0．02）。治疗后不同预后患者的TPS和NSE浓度差异有统计学意义（Z分别为4．06、3．11，P分别为0．001、0．007）。多指标联合检测时，以TPS＋NSE组合的敏感度最高（86．7％），其特异度、阳性预测值（PPV）和阴性预测值（NPV）分别为75．0％、81．0％和82．2％。结论血清TPS、NSE、CA125和CEA均可作为SCLC的诊断指标，以TPS＋NSE联合检测的临床价值最好。Objective To investigate the clinical value of tissue polypeptide specific antigen （TPS）, neuron-specific enolase （NSE）, carcinoembryonic antigen （CEA） and CA125 in serum of small cell lung cancer （SCLC） patients and its significance in diagnosis and disease monitoring. Methods Serum levels of TPS was detected using ELISA and serum levels of NSE, CA125 and CEA was detected using ECL in 271 SCLC patients, 80 pulmonary benign disease patients and 224 normal healthy people. Diagnostic values of these tumor markers were analyzed by receiver operative characteristic （ROC） curve. Results The levels of TPS, NSE, CA125 and CEA in the serum of SCLC group were significantly higher than those in pulmonary benign disease and healthy group （Z 〉 1.90,P 〈0.01 ）. The levels of TPS and NSE in the serum of extensive stage small cell lung cancer （ESCLC） patients were significantly higher than those in limited stage small cell lung cancer （LSCLC） （ Z = 2.69,2.27, P = 0. 009,0. 02 respectively）. The level of TPS and NSE showed statistical significance among SCLC patients with different prognosis after therapy （Z = 4.06,3. 11 ,P = 0. 001, 0. 007 respectively）. The TPS ＋ NSE showed the highest sensitivity of 86. 7%, and the specificity, PPV and NPV were 75.0%, 81.0% and 82.2%, respectively. Conclusions Serum levels of TPS, NSE, CA125 and CEA are useful for SCLC diagnosis. TPS ＋ NSE shows the highest clinical values in SCLC diagnosis and prognosis.

关 键 词：癌 小细胞 组织多肽特异性抗原 CA-125抗原 癌胚抗原 

分 类 号：R686[医药卫生—骨科学]