肺癌术中胸腔积液CEA、CYFRA21-1及NSE联检对术后胸膜转移的预测价值  

The Value of Combination Detections of Intraoperative Pleural Effusion CEA,CYFRA21-1 and NSE for Forecasting Pleural Metastasis in Lung Cancer Patients

作　　者：臧琦[1] 蒋仲敏[1] 王伟[1] 

机构地区：[1]山东省千佛山医院胸外科,山东省济南市250014

出　　处：《医学理论与实践》2008年第11期1261-1263,共3页The Journal of Medical Theory and Practice

基　　金：山东省自然科学基金(2004ZX10)

摘　　要：目的：探讨术中胸腔积液CEA和CYFRA21-1及NSE联检对肺癌患者术后胸膜转移的预测价值。方法：术中采集35例肺癌患者的胸腔积液，应用电化学发光免疫分析（DCLIA）技术，进行CEA和CYFRA21-1及NSE联检。结果：肺癌组CEA、CYFRA21-1和NSE水平明显高于良性疾病组，分别为：（272．56±144．81）μg/L和（3．72±1．94）μg／L（t=-2．335，P=0．023）；（252．20±171．91）μg／L和（45．46±34．74）μg／L（t=-5．296，P=0．000）；（107．30土88．53）μg/L和（43．66土29．88）μg／L（t=-3．105，P=0.003），差异有统计学意义；分别以大于8μg／L、102μg／L、92μg／L为阳性值，以其中2项或3项阳性为诊断依据，对胸膜微转移有较高的诊断灵敏度（74．3％）和特异度（100％）；术后随访2-3年，有12例患者术后出现癌性胸腔积液，其中腺癌6例，鳞状细胞癌和小细胞癌各3例。术后出现癌性胸腔积液中位时间为11．4个月。结论：此方法对肺癌术后胸膜转移有重要的预测价值。Objective：To discuss the value of combination detections of intraoperative pleural effusion CEA, CYFRA21-1 and NSE for forecasting pleural metastasis in lung cancer patients. The pleural effusions were collected from 35 malignant pulmonary cases during operation, then the pleural effusion CEA, CYFRA21-1 and NSE were assayed by ECLIA Results： The levels of CEA, CYFRA21-1 and NSE in patients with lung cancer were significantly higher than those in patients with benign lung disease[（272.56±144.81）μg/L and（3.72±1.94）μg/L,t=-2.335,P=0.023）];（252.20±171. 91）μg/L and （45.46±34.74）μg/L,t=-5.296,P=0.000）;（107.30±88.53）μg/L and（43.66±29.88）μg/L,t=-3.105,P=0.003）], there was notable differences. The cutoff limits were bigger than 8μg/L, 102μg/L and 92μg/L, respectively, 2 or 3 of those positive figures could be regarded as diagnostic.evidence This method has high sensitivity（74.3%） and specificity （100%） for the di- agnosis of pleural micrometastasis. The postoperative follow-up lasting 24 to 36 months showed that there were 12 cases suffered from malignant pleural effusion, including 6 adenocarcinoma, 3 squamous cell carcinoma and 3 of small cell carcinoma cases. The mean time for developing malignant pleural effusion after operation was 11.4 months Conclusion： This method con- tributes to forecast pleural metastasis, especially to the pulmonary adenocarcinoma metastasis after operation.

关 键 词：肺癌 胸膜转移 预测 CEA CYFRA21-1 NSE 

分 类 号：R734.2[医药卫生—肿瘤] R446.8[医药卫生—临床医学]