痰液癌胚抗原、癌抗原125、糖链抗原19—9和细胞角蛋白21—1片段检测对肺癌的诊断价值  

Diagnostic value of carcinoembryonic antigen, cancer antigen 125, carbohydrate antigen 19-9 and cytokeratin 21-1 fragment assays of sputum in patients with lung cancer

作　　者：刘大鹰[1] 胡灼君[1] 农天雷[2] 林敏[2] 

机构地区：[1]广西壮族自治区柳州市柳铁中心医院呼吸内科,545007 [2]广西壮族自治区柳州市柳铁中心医院核医学科,545007

出　　处：《中国医师进修杂志》2011年第19期4-8,共5页Chinese Journal of Postgraduates of Medicine

基　　金：广西壮族自治区柳州市科技局基金（2009021525）

摘　　要：目的检测痰液中癌胚抗原（CEA）、癌抗原125（CA125）、糖链抗原19—9（CA19-9）和细胞角蛋白21—1片段（CYFRA21—1）的含量，探讨痰液中肿瘤标志物检测在肺癌诊断中的意义。方法采用化学发光免疫分析法检测52例肺癌（肺癌组）和46例肺部良性病变患者（对照组）痰液中CEA、CAl25、CA19—9和CYFRA21．1的含量。结果肺癌组痰液中CEA、CA125、CA19—9和CYFRA21—1的含量分别为（27．6±31．2）μg／L、（76．4±65．2）kU／L、（56．1±31．6）kU／L和（25．2±9．1）μg／L；对照组分别为（6．1±7．5）μg/L、（23．7±7．9）kU／L、（17．3±10．2）kU／L和（1．2±1．7）μg／L，两组比较差异均有统计学意义（P〈0．01）。肺癌组痰液中CEA、CA125、CA19—9和CYFRA21—1的敏感度分别为42．3％（22／52）、46．2％（24／52）、36．5％（19／52）和51．9％（27／52），四种肿瘤标志物单项在肺癌中的敏感度比较差异均无统计学意义（P〉0．05）。腺癌CEA阳性率高于鳞癌（χ2=4．193，P〈0．05），CYFRA21—1阳性率低于鳞癌（χ2=4．806，P〈0．05）。III期＋Ⅳ期肺癌患者CAl25的阳性率较I期＋Ⅱ期高（r=5．202，P〈0．05）。痰液中单项肿瘤标志物的检测阳性率不高，含CYFRA21—1的两项、三项、四项检测组合阳性率明显提高（P〈0．05）。结论检测痰液中肿瘤标志物CEA、CA125、CA19—9和CYFRA21—1对肺癌的诊断具有一定的意义，联合检测痰液肿瘤标志物获得更高的阳性率和准确度，对肺癌的诊断具有较高的实用价值。Objective To evaluate the clinical significance of carcinoembryonic antigen （CEA）, cancer antigen 125 （CA125）,carbohydrate antigen 19-9 （CA19-9） and cytokeratin 21-1 fragment （CYFRA21-1） assays of sputum in patients with lung cancer. Method Fifty-two cases with lung cancer and 46 eases with benign lung diseases underwent detection of CEA, CA 125, CA 19-9 and CYFRA21-1 in sputum by using the method of chemi-luminescent enzyme immunoassay. Results The levels of CEA,CA125, CA19-9 and CYFRA21-1 in sputum of 52 cases with lung cancer were （27.6± 31.2） μg/L, （76.4 ± 65.2） kU/L, （56.1± 31.6 ） kU/L and （25.2 ± 9.1 ） μg/L respectively. But the levels of those of 46 eases with benign lung diseases were （6.1±7.5）μg/L, （23.7 ±7.9） kU/L, （17.3 ± 10.2） kU/L and （1.2 ± 1.7）μg/L respectively. The levels of these tumor markers in sputum in patients with lung cancer were significantly higher than those in patients with benign lung diseases（P 〈 0.01 ）. The diagnostic sensitivity of CEA, CA125, CA19-9 and CYFRA21-1 in sputum in 52 cases with lung cancer was 42.3%（22/52） ,46.2%（24/52） ,36.5% （ 19/52 ） and 51.9% （27/52） respectively （P 〉 0.05 ）. Among the cancer patients, the sensitivity of sputum CEA in patients with adenoeareinoma was significantly higher than that in patients with squamous cell carcinoma（χ2 = 4.193, P 〈 0.05 ）;while the sensitivity of sputum CYFRA21-1 in patients with squamous cell carcinoma was significantly higher than that in patients with adenocarcinoma （ χ2 = 4.806,P 〈 0.05 ）. The sensitivity of CA 125 in advanced lung cancer（ III ＋ IV stage） was higher than that in early lung cancer（ I ＋ II stage） （ χ2 = 5.202,P 〈 0.05 ）. Compared with the single tumor marker assaying, the combination of CEA, CA125, CA19-9 and CYFRA21-1 in sputum could significantly improve the sensitivity and accurate value in the diagnosis of lung cancer （P〈 0.05）. Conclusion To assay CEA,CA125,CA19-9 and CYFRA21-1

关 键 词：肺肿瘤 肿瘤标记 生物学 痰 诊断 

分 类 号：R734.2[医药卫生—肿瘤]