肿瘤标志物在非小细胞肺癌患者诊断中的价值  

The value of serum tumour marker in the diagnosis of patients with nonsmall cell lung cancer

作　　者：尹竺晟 戈伟[1] 罗卫[1] 

机构地区：[1]武汉大学人民医院肿瘤中心,湖北武汉430000

出　　处：《中国医药导报》2016年第23期102-105,共4页China Medical Herald

基　　金：国家自然科学基金资助项目(30970860)

摘　　要：目的评价4种肿瘤标志物细胞角蛋白19血清片段21—1（CYFRA21—1）、鳞状细胞癌相关抗原（SCC）、癌胚抗原（CEA）和糖类抗原（CA125）在初诊非小细胞肺癌患者诊断中的价值。方法分析2010年5月-2013年10月武汉大学人民医院胸外科初诊的经手术活检确诊的非小细胞肺癌患者174例纳入本研究。在手术或化疗之前检测患者CYFRA21—1、SCC、CEA和CA125的血浆水平。另外共67例肺部良性疾病患者作为肺部良性疾病组。分析单项与联合检测4种肿瘤标志物在非小细胞肺癌患者诊断中的价值。结果肺癌患者的4种血清肿瘤标志物水平均高于肺部良性疾病组，差异有统计学意义（P〈0．05）。SCC在肺鳞癌患者中阳性率高于肺腺癌，差异有统计学意义（P〈0．05）。在Ⅲ／Ⅳ期患者中CEA、CA125的阳性率高于Ⅰ／Ⅱ期患者，差异有统计学意义（P〈0．05）。单项检测血清肿瘤标志物Cyfra21—1在肺癌、肺鳞癌、肺腺癌的诊断敏感度最高，在非小细胞肺癌患者或肺鳞癌患者中，4种联合检测的敏感度均高于CEA、CA125、SCC3种血清肿瘤标志物单项检测，差异有高度统计学意义（P〈0．01），在肺腺癌中，4种联合检测的敏感度均高于CEA、SCC2种血清肿瘤标志物单项检测．差异有高度统计学意义（P〈0．01）。4种联合检测可以提高诊断的敏感度，而特异度均无明显差异（P〉0．05）。结论4种血清肿瘤标志物联合检测可以提高诊断的敏感度，对初诊非小细胞肺癌患者诊断有一定的临床意义。Objective To evaluate the clinical value of tumor markers CYFRA21-1; SCC, CEA and CA125 in the diagnosis of patients with non-small cell lung cancer （NSCLC）. Methods A total of 174 untreated NSCLC patients from Thoracic Surgery of Renmin Hospital of Wuhan University confirmed by surgical biopsy were enrolled from May 2010 to October 2013 in the present study. Serum levels of CYFRA 21-1, CEA, CA125 and SCC were measured before surgery. 67 cases with benign pulmonary disease were selected as the benign disease group. The diagnostic significance of single or combination lung cancer-related serum turnout markers in NSCLC were analyzed. Results The serum levels of CYFRA21-1, SCC, CEA and CA125 in the NSCLC group were significantly higher than those of the benign disease group, the differences were statistically significant （P 〈 0.05）. The positive rate of SCC in patients with squamous cell carcinoma was significantly higher than that of in patients with adenocarcinoma, the difference was statistically significant （P 〈 0.05）. The positive rate of CEA, CA125 in patients with stage Ⅲ/Ⅳ was significantly higher than that of in patients with stage Ⅰ /Ⅱ, the difference was statistically significant （P 〈 0.05）. CYFRA21-1 showed the highest sensitivity for the diagnosis of squamous cell carcinoma, adenocareinoma and non-small lung cancer. The sensitivity of 4 kinds of markers combined detection was higher than those of CEA or CA125 or SCC individual testing in patients with NSCLC or squamous cell carcinoma, the difference was statistically significant （P 〈 0.01）, and higher than those of CEA or CA125 individual testing in patients with adenocarcinoma, the difference was statistically significant （P 〈 0.01）. 4 kinds of markers combined detection could improve the sensitivity of the diaznosis, but the specificity had no statistically significant （P 〉 0.05）. Conclusion The combined detection of the tested tumor markers of CYFRA 21-1, CEA, CA125 and SCC can improve the sensitivity

关 键 词：癌胚抗原 糖类抗原 细胞角蛋白19血清片段21—1 鳞状细胞癌相关抗原 非小细胞肺癌 

分 类 号：R734[医药卫生—肿瘤]