四项肿瘤标记物在肺癌中的表达及其相关因素分析  

Expression and analysis of four tumor markers in patients with lung cancer

作　　者：牛继国[1] 呼永华[2] 董峰[1] 梅澍[1] 赵瑞萍[1] 包晓玲 曾贤伍[1] 李文燕[1] 达选祯[1] 

机构地区：[1]甘肃省肿瘤医院核医学科,兰州730050 [2]甘肃省肿瘤医院呼吸内科,兰州730050 [3]甘肃医药杂志编辑部,兰州730050

出　　处：《国际检验医学杂志》2011年第20期2330-2333,共4页International Journal of Laboratory Medicine

摘　　要：目的通过检测肿瘤标志物癌胚抗原(CEA)、细胞角蛋白l9片段21-1(CYFRA21-1)、神经元特异性烯醇化酶(NSE)和血清铁蛋白(SF)在肺癌患者血清中的表达及其相关因素分析探讨CEA、CYFRA21-1、NSE、SF的临床应用价值。方法采用电化学发光免疫技术分别对39例体检健康人员和196例肺癌患者的血清标本进行CEA、CYFRA21-1、NSE、SF的含量检测。结果肺癌组血清与对照组相比均明显升高,差异有统计学意义(P<0.01);诊断效能ROC分析显示,CEA、CYFRA21-1、NSE和SF曲线下面积分别为0.824、0.734、0.809和0.787,对肺癌具有诊断意义(P<0.01);血清CEA、CYFRA21-1、NSE和SF四项联合检测阳性率81.6%,其中对肺腺癌为74.6%,肺鳞癌为91.3%,小细胞肺癌为75.5%,均高于单项检测及前三项联合检测。四项肿瘤标记物的表达与肺腺癌、肺鳞癌、小细胞肺癌、肝转移、骨转移等因素之间有不同的直线相关关系。结论四项肿瘤标志物联合检测有助于肺癌的诊断及病理类型鉴别,对其病程推断、脏器转移监测、预后等具有一定的临床价值。Objective To detect the levels of four serum tumor markers such as CEA,CYFRA21-1,NSE and SF in patients with lung cancer,respectively.Then to analyze the relevant factors and evaluate the clinical values of these tumor markers.Methods The levels of serum CEA,CYFRA21-1,NSE and SF in 196 patients with lung cancer and 39 controls were determined by electro-chemiluminescence immunoassay（ECLIA）.Results It was found that the levels of serum CEA,CYFRA21-1,NSE and SF in patients with lung cancer were significantly higher than those in the controls（P0.01）.ROC analysis of diagnosis efficiency showed that the areas under curve（AUC） for CEA,CYFRA21-1,NSE and SF were 0.824,0.734,0.809 and 0.787,respectively（P0.01）.Positive rates of combination detection of four tumor markers were 91.3% in squamous,74.6% in adenocarcinoma and 75.5% in small cell lung cancer（SCLC）,respectively,as well as total positive rate was 81.6%.All of them were higher than these of the detections of single tumor maker or combination detection of CEA,CYFRA21-1 and NSE.Additionally,Stepwise regression analysis showed that there were different linear relations of the expressions of CEA,CYFRA21-1,NSE and SF with the adenocarcinoma,squamous,small cell lung cancer,metastasis of liver and bone.Conclusion The combined detection of serum CEA,CYFRA21-1,NSE and SF can increase the diagnostic sensitivity of lung cancer,and would be clinical useful for predicting pathologic type,monitoring the metastasis of liver and Bone,and prognosis in patients with lung cancer.

关 键 词：肺肿瘤 肿瘤标记 生物学 表达 影响因素 

分 类 号：R734.2[医药卫生—肿瘤]