纤支镜检查联合痰液肿瘤标志物检测对肺癌的诊断价值  

Diagnostic Value of Fibro-Optic Bronchoscope Examination Combined with Tumor Marker Assays in Sputum Analysis of Patients with Lung Cancer

作　　者：刘大鹰[1] 胡灼君[1] 农天雷[1] 林敏[1] 

机构地区：[1]广西柳州市柳铁中心医院呼吸内科核医学科,广西柳州545007

出　　处：《中国临床医学》2011年第4期433-436,共4页Chinese Journal of Clinical Medicine

基　　金：广西柳州市科技局攻关项目(编号:2009021525)

摘　　要：目的：探讨纤维支气管镜检查联合痰液肿瘤标志物检测对肺癌的诊断价值。方法：对52例肺癌患者和46例肺部良性病变患者行纤维支气管镜检查,并采用化学发光免疫分析法检测其痰液中的肿瘤标志物。结果：52例肺癌患者痰液中癌胚抗原（CEA）、糖类抗原125（CA125）、糖尿抗原19-9（CA199）和细胞角蛋白19片段21-1（CYFRA21-1）的阳性率分别为42.3%、46.2%、36.5%和51.9%;46例肺部良性病变患者的阳性率分别为13.0%、15.2%、10.7%和17.4%。比较2组阳性率差异有统计学意义（P〈0.05）。52例肺癌患者中纤维支气管镜检查确诊30例,敏感度为57.7%,特异度和准确度分别为100.0%和77.6%。鳞癌患者痰液CYFRA21-1阳性率较CEA、CA125、CA199升高更显著（P=0.028）。Ⅲ期＋Ⅳ期肺癌患者痰液CA125的阳性率较Ⅰ~Ⅱ期高（P=0.023）。纤维支气管镜检查联合痰液肿瘤标志物检测的敏感度为94.2%,特异度和准确度分别为87.0%和90.8%。结论：纤维支气管镜检查联合痰液肿瘤标志物检测可以提高肺癌的诊断水平。Objective：To investigate the diagnosis value of undergoing fibro-optic bronchoscope（FB） examinations combination with tumor marker（TM） assays in sputum to lung cancer.Methods：By fibro-optic bronchoscope examinations and using the method of chemi-luminescent enzyme immunoassay for the assay of tumor marker in sputum,52 cases with lung cancer and 46 cases with benign lung disease were studied.Results： Among the 52 cases of lung cancer,the positive percentage of carcinoembryonic antigen（CEA）,cancer antigen（CA）125,CA199 and cytokeratin 19 fragment antigen 21-1（CYFRA21-1） in sputum analysis were 42.3%,46.2%,36.5% and 51.9%,respectively;while the positive percentage of the 46 cases with benign lung disease were 13.0%、15.2%、10.7% and 17.4%,respectively（P0.05）.The sensitivity,specificity and overall accuracy of FB were 57.7%,100.0% and 77.6%,respectively.Among the patients with squamous cell carcinoma,the sensitivity of CYFRA21-1 in sputum analysis was significantly higher than those of CEA、CA125 and CA199 in sputum analysis（P=0.028）.The sensitivity of CA125 in advanced lung cancer was higher than those in early lung cancer（P=0.023）.The sensitivity,specificity and overall accuracy of fibro-optic bronchoscope combination with tumor marker assays in sputum to diagnosis of lung cancer were 94.2%,87.0% and 90.8%,respectively.Conclusions： The FB examinations is a valuable method in diagnosing lung cancer,and the FB combined with tumor marker assays in sputum can further improve sensitivity and accurate value in the diagnosis of lung cancer.

关 键 词：肺肿瘤 肿瘤标志物 痰液 纤维支气管镜 

分 类 号：R734.2[医药卫生—肿瘤]