检测支气管肺泡灌洗液中肿瘤标记物水平对原发性肺癌诊断的意义  

Study on the significance of tumor markers in bronchoalveolar lavage fluid for diagnosis of primary lung cancer

作　　者：刘国田 王瑞芹 崔蓉 蔡善花 安树昌 李兵 骆文玲 

机构地区：[1]清华大学第一附属医院呼吸科,北京100016

出　　处：《临床和实验医学杂志》2017年第18期1807-1809,共3页Journal of Clinical and Experimental Medicine

基　　金：北京市自然科学基金面上项目(编号:7102121)

摘　　要：目的探讨支气管肺泡灌洗液中肿瘤标记物水平对原发性肺癌诊断的意义,为原发性肺癌的诊断提供参考。方法选取86例原发性肺癌患者(肺癌组)及63例肺良性疾病患者(良性病变组)作为研究对象,采用支电化学发光法测定支气管肺泡灌洗液中的癌胚抗原(CEA)、细胞角质素片断抗原(CYFRA21-1)、神经元特异性烯醇化酶(NSE)、鳞状细胞癌相关抗原(CC-Ag)的水平,并进行对比分析。结果肺癌组支气管肺泡灌洗液中4项肿瘤标志物水平显著高于良性病变组(P<0.05);CEA在腺癌中的阳性检出率最高(P<0.05);CYFRA21-1在非小细胞癌中阳性检出率明显高于小细胞癌组(P<0.05);NSE在小细胞肺癌中阳性率最高(P<0.05);SCC-Ag在鳞癌中阳性率最高(P<0.05)。支气管肺泡灌洗液中4项肿瘤标记物联合检测诊断原发性肺癌的敏感度达86.05%,准确性达77.18%,均高于单项检测。结论支气管肺泡灌洗液中4项肿瘤标记物的检测均可作为原发性肺癌的诊断指标,并在肺癌临床诊断分型诊断及治疗有指导意义,4项肿瘤标记物联合检测有助于提高原发性肺癌诊断的敏感度和准确性。Objective To explore the significance of tumor markers in bronchoalveolar lavage fluid for diagnosis of primary lung cancer.Methods 86 patients with primary lung cancer（ lung cancer group） and 63 patients with benign pulmonary diseases（ benign disease group） were allocated for this study. The levels of CEA,CYFRA21-1,NSE and SCC-Ag of BALF were determined by electrochemiluminescent immunoassay. All these data were analyzed. Results The levels of four tumor markers in lung cancer group were higher than those of benign disease group（ P〈0. 05）. The positive rate of CEA in lung adenocarcinoma group,CYFRA21-1 in non-small cell lung carcinoma group,NSE in small cell lung carcinoma group and SCC-Ag in lung squamous cell carcinoma group were significantly different from other kinds of pathological types. The sensitivity of combination detection of these four tumor markers was 86. 05%,the veracity was 77. 18%,which was significantly higher than that of detection by single marker. Conclusion The four tumor markers may be applied for diagnosis of primary lung cancer. At the same time,it should be valuable for determination of clinical stage,histological type and follow-up studies of lung cancer. The combined detection of tumor markers in BALF would significantly enhance the sensitivity and accuracy of diagnosis for primary lung cancer.

关 键 词：原发性肺癌 支气管肺泡灌洗液 肿瘤标记物 

分 类 号：R734.2[医药卫生—肿瘤]