多种肿瘤标志物的联合检测诊断肺癌的临床价值  

Clinical Value of Combination of Multiple Tumor Markers in Diagno- sis of Lung Cancer

作　　者：李远平[1] 彭华利[1] 龙永贵[1] 张帆[1] 

机构地区：[1]乐山市人民医院胸心外科,四川省乐山市614000

出　　处：《医学分子生物学杂志》2015年第5期286-289,共4页Journal of Medical Molecular Biology

摘　　要：目的探讨癌胚抗原（carcino．embryonicantigen，CEA）、肿瘤相关抗原（CA-125）、鳞癌相关抗原（SCC-Ag）、神经元特异性烯醇化酶（Neuron．specificenolase，NSE）、细胞角蛋白21-1（CYFRA21-1）肿瘤标志物联合诊断肺癌的应用价值。方法选取在我院门诊就诊的165例肺癌患者，104例良性肺部疾病患者，并选取同期体检的30名健康人作为对照组，对3组患者的血清CEA、CA-125、SCC—Ag、NSE、CYFRA21—1进行对比分析。结果肺癌组患者CEA、CA-125、SCC—Ag、NSE、CYFRA21—1指标水平明显高于肺部疾病组和对照组，差异有统计学意义（P〈0．05）。肺癌的诊断中肿瘤标志物单项检测的灵敏度CY—FRA21-1最高为55．15％．特异度SCC．Ag最高为94．43％。而5项联合指标检测的灵敏度较高，为91．24％，特异度相对较低，为63．75％，差异有统计学意义（P〈0．05）。在不同的肺癌类型单项检测中，SCC—Ag在小细胞肺癌中有较高的价值，而鳞癌和腺癌中具有较高价值的则分别为CEA和CA125。联合多项指标检测中均具有较高的阳性值，差异有统计学意义（P〈0．05），结论多项肿瘤标志物联合诊断肺癌具有较高的价值．单项肿瘤标志物预测不同的肺癌病理类型有明显的意义。Objective To investigate the application value of combination of multiple tumor markers [ carcinoembryonic antigen （ CEA）, a tumor-associated antigen （ CA-125 ）, squamous cell carcinoma associated antigen （SCC-Ag）, neuron-specific enolase （NSE）, cytokeratin 21-1 （CY- FRA21-1 ） ] in the diagnosis of lung cancer. Methods A total of 165 patients with lung cancer and 104 patients with benign lung diseases who were treated at our hospital were included in the stud- y. Thirty healthy people who underwent physical checkup at the same time period served as con- trols. The serum levels of CEA, CA-125, SCC-Ag, NSE, CYFRA21-1 were detected in these sub- jects and analyzed after comparison between groups. Results Serum levels of CEA, CA-125, SCC-Ag, NSE, and CYFRA21-1 were significantly higher in lung cancer patients than in patients with benign lung diseases and healthy people and the difference was statistically significant （P 〈 0. 05） . In single tumor marker detection, the sensitivity of CYFRA21-1 was highest, reaching 55.15% , and SCC-Ag had the highest specificity of 94. 43 %. The sensitivity of combined detection of the five tumor marker had a highest sensitivity of 91.24 % and a relatively lower specificity of 63.75 （ P 〈 0. 05 ） . In use of single tumor marker for detection of different types of lung caneer, SCC-Ag had a high value in diagnosis of small cell lung cancer, and high levels of CEA and CA125 indicated squamous cell carcinoma and adenocarcinoma. Combined detection of a number of tumor markers had a high positive value in diagnosis of these diseases. Conclusion Combined detection of multiple tumor markers has a higher value in diagnosis of lung cancer. The individual tumor markeris of significance in prediction of lung cancer of different pathological types.

关 键 词：肺癌 癌胚抗原 肿瘤相关抗原-125 鳞癌相关抗原 细胞角蛋白21—1 

分 类 号：R734.2[医药卫生—肿瘤]