肿瘤标志物与纤支镜刷检联合检查对肺癌的诊断价值  

The Diagnostic Value of Tumor Markers Combined with Fiberoptic Bronchoscopic Brushing in Lung Carcinoma

作　　者：于瑞珍 黄梦桃 

机构地区：[1]山东省临沂市肿瘤医院,山东临沂276001 [2]中国同辐股份有限公司,北京100045

出　　处：《标记免疫分析与临床》2014年第4期360-363,共4页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨肿瘤标志物与纤维支气管镜刷检液基细胞技术(liquid-based cytology test,LCT)联合检查观察对肺癌的诊断价值。方法采用快速准确特异的电化学发光免疫技术检测256例患者血液中的癌胚抗原(carcinombryonic antigen,CEA)、神经元特异度烯醇化酶(neuron-specific enolase,NSE)、细胞角蛋白19片段(cytokerantin-19-fragment,CYFRA21-1)和糖类抗原125(cancer ntigen,CA125)4种肿瘤标志物的含量水平;同时行纤维支气管镜检查,刷检物分别应用传统涂片(conventional smear,CS)、薄层液基细胞制片技术(liquid-based cytology test,LCT);行瑞氏、HE染色检查肿瘤细胞。结果在256例患者中,肺癌组肿瘤标志物明显高于肺良性疾病组(P<0.05)。四种肿瘤标志物联合检测其敏感度为80.47%,明显高于单项、两项检测,差异有统计学意义(P<0.05)。纤支镜刷检液基细胞学确诊肺癌215例,包括鳞癌80例、腺癌66例、小细胞癌69例。纤维支气管镜刷检敏感度为92.09%,四种肿瘤标志物与纤支镜刷检液基细胞学联合检查敏感度达到94.42%。结论血清肿瘤标志物联合纤维支气管镜刷检液基细胞学检查可显著提高肺癌诊断率。Objective To explore the clinical value of serum tumor markers combined with fiberoptic bronchoscopic brushing in diagnosis of lung carcinoma. Methods The serum levels of carcinombryonic antigen （CEA）, neuron-specific enolase （NSE）, cytokerantin-19- fragment （ CYFRA21-1 ） and cancer antigen 125 （CA125） in 256 patients with lung cancer were detected by electrochemiluminescent. The tumor ceils were examined by conventional smear （CS） and thin layer of liquid-based cytology test （LCT） with Wright＇s staining and HE staining through fiber bronchoscopic examination, respectively. Results The serum levels of the tumor markers in patients with lung cancer group were higher than that with benign pulmonary disease （P 〈 0.05 ）. The sensitivity of combination detection with the 4 tumor markers was 80.47%, There was higher statistical significance than single or either marker （P 〈 0.05 ）, Lung cancer was diagnosed by thin layer of liquid- based cytology test through fiberoptic bronchoscopic brushing cytology in 215 patients, in which 80 were squamous carcinoma, 66 were adenocarcinoma and 69 were small cell carcinoma. The sensitivity of fiberoptic bronchoscopic brushing cytologic test was 92.09%. The sensitivity of LCT and fiber bronchoscopic examination combined with the tumor markers was 94.42%. Conclusion The serum tumor markers combined with LCT through fiber bronchoscopic examination may improve the diagnostic rate in lung carcinoma.

关 键 词：肿瘤标志物 纤维支气管镜 细胞学 肺癌 

分 类 号：R734.2[医药卫生—肿瘤]