血清细胞角蛋白19片段检测对肺癌的临床意义  

Clinical usefulness of a new tumor marker CYFRA21 1 in patients with lung cancer

作　　者：李睿[1] 李蓉[1] 王亚文[1] 

机构地区：[1]西安医科大学第一临床医学院

出　　处：《中华结核和呼吸杂志》1998年第1期26-29,共4页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的确定我国肺癌患者血清细胞角蛋白１９片段（ＣＹＦＲＡ２１－１）浓度阈值，探讨其临床应用价值。方法应用单克隆抗体（Ｋｓ１９．１和ＢＭ１９．２１）检测７２例初次确诊肺癌患者和５０例肺良性疾病患者以及３３例治疗后肺癌患者血清ＣＹＦＲＡ２１－１水平。采用ＲＯＣ曲线确定ＣＹＦＲＡ２１－１浓度阈值。结果（１）肺癌患者血清ＣＹＦＲＡ２１－１水平显著高于肺良性疾病患者（Ｐ＜０．００１），鳞癌显著高于其它病理类型，且其浓度随临床分期升高而升高。（２）当阈值定为５．５μｇ／Ｌ时，ＣＹＦＲＡ２１－１检测肺癌的敏感性、特异性分别为６３％和９４％。鳞癌敏感性最高为７８％。（３）ＣＹＦＲＡ２１－１检测非小细胞肺癌的敏感性随临床分期升高而升高。（４）ＣＹＦＲＡ２１－１是监测肺癌病情、提示疗效的良好指标。（５）当ＣＹＦＲＡ２１－１作为筛检肺癌的指标时，阈值宜取非小细胞肺癌Ｉ－ＩＩ期ＲＯＣ曲线拐点，但对非小细胞肺癌早期诊断作用有限。结论ＣＹＦＲＡ２１－１是一较好的非小细胞肺癌肿瘤标记物。Objective To set the serum cut off value of CYFRA21 1 in lung cancer patients in china,and to evaluate the clinical usefulness of CYFRA21 1 as a new tumor marker of lung cancer. Methods CYFRA21 1 levels were measured with two monoclonal antibodies (Ks19.1 and BM19.21) in the serum of 72 patients with lung cancer, 50 patients with benign lung diseases and 33 post therapy lung cancer patients. To set the cut off value, ROC curve was used. Results (1) Serum concentrations of CYFRA21 1 in patients with lung cancer were significantly higher than those with benign lung diseases ( P <0.001). CYFRA21 1 levels in patients with squamous cell carcinoma were significantly higher than those in patients with any other subtypes. The more advanced the clinical stages , the higher the levels of CYFRA21 1. (2) If the threshold of CYFRA21 1 was set at 5.5 μg/L, its sensitivity and specificity for lung cancer were 63 % and 94%, respectively. The sensitivity for squamous cell carcinoma was 78%, which was the highest among all the pathological subtypes. (3) The sensitivity of CYFRA21 1 in non small cell lung cancer increased with the advancement of clinical stages. (4) CYFRA21 1 could be a good index in monitoring patient′s condition and predicting prognosis for lung cancer. (5) When CYFRA21 1 was used as a screening index for lung cancer, the threshold of CYFRA21 1 should be set at the upper left corner of the receiver operating characteristic curve of stage I II. The value of CYFRA21 1 in early diagnosis for non small cell lung cancer was found limited. Conclusion CYFRA21 1 is a sensitive and specific tumor marker of non small cell lung cancer, especially of squamous cell carcinoma.

关 键 词：肺肿瘤 血清 细胞角蛋白 CYFRA21-1 

分 类 号：R734.204[医药卫生—肿瘤]