血清TAM、NSE、SCC—Ag,Cyfra21—1联合检测在肺癌诊断中的临床价值  

Clinical value of detection of serum TAM, NSE, SCC - Ag and Cyfra21 - 1 in diagnosis of lung cancer

作　　者：杨常建 景晓刚[2] 

机构地区：[1]平煤神马医疗集团总医院肿瘤科,河南平顶山467000 [2]郑州大学第一附属医院呼吸内科,河南郑州450052

出　　处：《徐州医学院学报》2014年第10期672-675,共4页Acta Academiae Medicinae Xuzhou

摘　　要：目的探讨血清肿瘤相关物质（TAM）、神经元特异性烯醇化酶（NSE）、鳞状细胞癌抗原（SCC-Ag）、细胞角蛋白19片断（Cyfra21-1）联合检测用于肺癌诊断的临床价值。方法检测77例肺癌（肺癌组）、30例肺良性疾病（肺良性疾病组）、42名正常体检者（正常对照组）的血清肿瘤标志物TAM、NSE、SCC-Ag、Cyfra21-1水平，比较3组患者4种血清肿瘤标志物表达的差异及不同病理类型肺癌患者4种血清肿瘤标志物表达的差异。结果①肺癌组血清TAM、NSE、SCC-Ag、Cyfra21-1水平明显高于肺良性疾病组和正常对照组（P〈0．01）；小细胞肺癌组血清NSE水平显著高于鳞癌组和腺癌组（P〈0．05），鳞癌组血清SCC-Ag、Cyfra21-1水平均高于腺癌组和小细胞肺癌组（P〈0．05），TAM水平在3种病理类型间的差异无统计学意义（P〉0．05）。②肺癌组单检TAM、NSE、SCC-Ag、Cyfra21-1及联检（TAM＋NSE＋SCC-Ag＋Cyfra21-1）阳性率分别高于肺良性疾病组和正常对照组（P〈0．01）；小细胞肺癌组NSE阳性率显著高于鳞癌组和腺癌组（P〈0．05）；鳞癌组SCC-Ag、Cyfra21-1阳性率均高于腺癌组和小细胞肺癌组（P〈0．05）。③单检TAM、NSE、SCC-Ag、Cyfra21-1与联检（TAM＋NSE＋SCC-Ag＋Cyfra21-1）对肺癌诊断的灵敏度分别为81．87％、42．86％、29．87％、53．25％、93．51％，特异度分别为90．3％、97．2％、98．6％、95．8％、88．9％，准确性分别为85．9％、69．1％、63．1％、73．8％、90．6％，联合检测能获得较高的灵敏度和准确性。结论血清TAM、NSE、SCC-Ag、Cyfra21-1检测对肺部良恶性肿瘤的鉴别及判断肺癌病理类型有重要临床价值，4种肿瘤标志物联合检测能进一步提高肺癌诊断的敏感性和准确性。Objective To study the clinical value of combined detection of serum tumor associated material （TAM）, neuron- specific enolase （NSE）, squamous cell carcinoma antigen （SCC -Ag）, and Cyfra21 - 1 for diagnosis of lung cancer. Methods Serum levels of tumor markers TAM, NSE, SCC - Ag and Cyfra21 - 1 in 77 cases of lung cancer （lung cancer group）, 30 cases of benign lung disease （ benign lung disease group） and 42 normal subjects （ normal control group） were detected and compared among the three groups. The expression levels of these tumor markers in different histological types of lung cancer were also compared. Results （1）The serum levels of TAM, NSE, SCC - Ag and Cyfra21 - 1 in lung cancer were respectively higher than that in benign lung disease group and normal control group （P 〈 0.01 ）. Serum NSE levels in small cell lung cancer was significantly higher than that in squamous cell carcinoma group and adenocarcinoma group （ P 〈 0.05）. Serum SCC - Ag, Cyfra21 - 1 levels in squamous cell carcinoma were higher than that in adenocarcinoma cancer group and small cell lung cancer group （P 〈 0.05）. TAM level showed no significant difference among three pathological types （P 〉0.05）. （2）The single and joint positive rates of TAM, NSE, SCC -Ag, Cyfra21 -1 in lung cancer were respectively higher than that in benign lung disease group and normal control group （P 〈0. 01 ）. The positive rate of NSE in small cell lung cancer （77.78%） was significantly higher than that in squamous cell carcinoma group and adenocarcinoma group （P 〈0.05）. The positive rates of SCC - Ag, Cyfra21 - 1 in squamous cell carcinoma were higher than that in adenocarcinoma cancer group and small cell lung cancer group （P 〈0.05）. （3） The single and joint sensitivity in diagnosis of lung cancer was 81.87%, 42.86%, 29.87%, 53.25%, and 93.51%, respectively, the specificity was 90. 3%, 97.2%, 98.6%, 95.8%, and 88.9%, respectively, the accuracy was 85.9%, 69. 1%, 63. I%, 73.8%, and 9

关 键 词：肺肿瘤 肿瘤标志物 肿瘤相关物质 神经元特异性烯醇化酶 鳞状细胞癌抗原 细胞角蛋白19片断 

分 类 号：R734.2[医药卫生—肿瘤]