内参标化的灌洗液CEA在周围型肺癌中的价值  

Value of carcinoembryonic antigen in bronchoalveolar lavage fluid in the diagnosis of peripheral lung cancer by using endogenous marker to quantify the dilution

作　　者：方年新[1] 陈正贤[2] 

机构地区：[1]东莞市人民医院呼吸内科,广东东莞523000 [2]中山大学第六附属医院呼吸内科,广东东莞523000

出　　处：《临床肺科杂志》2015年第6期1000-1003,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的：探讨内参标化支气管肺泡灌洗液（ BALF）的CEA在周围型肺癌中的价值。方法对69例患者进行支气管肺泡灌洗（BAL）并测定血清及BALF中总蛋白、白蛋白、尿素氮、钾、CEA。结果1.两组CEA在血清和BALF差异均无统计学意义,内参标化后支气管肺泡灌洗液癌胚抗原（ BFCA）肺癌患者均高于非肺癌患者。2.各内参标化后BFCA对诊断肺癌曲线下面积均在0．70～0．90,白蛋白标化后BFCA选择截点为680．01ng/ml,灵敏度达96．9%,特异度为50%；尿素标化后 BFCA 选择截点127．24 ng/ml,灵敏度为59．4%,特异度为95．5%；钾标化后BFCA选择截点165．39 ng/ml,灵敏度为68．8%,特异度为86．4%；总蛋白标化后BFCA选择截点2595．29 ng/ml,灵敏度为53．1%,特异度为86．4%。结论内参标化后BFCA可除外稀释的影响,联合多个内参标化将更好的提高其灵敏度和特异度。Objective To investigate the diagnostic value of CEA by using endogenous marker to quantify the dilution to peripheral lung cancer in bronchoalveolar lavage fluid （ BALF） . Methods 69 patients were inspected with bronchoalveolar lavage （ BAL） , and their levels of total protein, albumin, urea nitrogen, potassium and CEA in serum and BALF were detected. Results 1. There was no significant difference in CEA in blood serum and BALF between the two groups. The level of BFCA in BALF was higher in the lung cancer group than in the non-lung cancer group by using endogenous marker to quantify the dilution. 2. The area under ROC curve of every diagnosis indicator was between 0. 70 and 0. 90. Taking 680. 01 ng/ml of BFCA as optimal cut-off in BALF by using albumin as endogenous marker to quantify the dilution, the sensitivity was 96. 9%, and the specificity was 50%. Taking 127. 24 ng/ml of BFCA as optimal cut-off in BALF by using urea nitrogen as endogenous marker, the sensitivity was 59. 4%, and the specificity was 95. 5%. Taking 165. 39 ng/ml of BFCA as optimal cut-off in BALF by using potassium as endogenous marker, the sensitivity was 68. 8%, and the specificity was 86. 4%. Taking 2595. 29 ng/ml of BFCA as optimal cut-off in BALF by using total protein as endogenous marker, the sensitivity was 53. 1%, and the specificity was 86. 4%. Conclusion The level of CEA in BALF by using endogenous marker to quantify the dilution can dismiss the effect of dilution, and the combined endogenous marker can improve the sensitivity and specificity.

关 键 词：支气管肺泡灌洗 内参 总蛋白 白蛋白 尿素 钾 周围型肺癌 

分 类 号：R734.2[医药卫生—肿瘤]