6种血清肿瘤标志物在肺癌辅助诊断中的应用评价  

The applications evaluate of six kinds of serum tumor markers in the auxiliary diagnosis of lung cancer

作　　者：卢兴兵[1] 石佳[1] 李勤[1] 曾素根[1] 江虹[1] 陈捷[1] LU Xingbing;SHI J ia;LI Qin;ZENG Sugen;JIANG Hong;CHE Jie(Department of Laboratory Medicine,Huaxi Hospital,Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]四川大学华西医院实验医学科,成都610041

出　　处：《检验医学与临床》2018年第18期2768-2772,2776,共6页Laboratory Medicine and Clinic

摘　　要：目的探讨肿瘤标志物神经元特异烯醇化酶(NSE)、细胞角蛋白21-1(CYfra21-1)、糖类抗原(CA)125、癌胚抗原(CEA)、CA199和乳酸脱氢酶(LDH)在肺癌辅助诊断中的应用评价。方法通过电化学发光和酶法检测292例肺癌患者、201例肺部良性病患者及215例健康体检者的6种血清标志物水平。结果 6种血清肿瘤指标在肺癌患者中的水平均明显高于肺部良性病和健康体检组(P<0.05);CYfra21-1和CA199结果水平在男性各组别显著高于女性,在鳞癌中的阳性率高于腺癌(P<0.05);小细胞肺癌NSE和LDH结果明显高于非小细胞肺癌,其阳性率显著高于腺癌,CA199和CEA结果显著低于非小细胞肺癌(P<0.05);CEA和LDH在腺癌和鳞癌之间差异有统计学意义(P<0.05);各血清标志物升高程度与肺癌TNM分期呈正相关(P<0.05);联合检测结果的敏感度和准确性明显高于单项检测。结论 6种血清标志物在肺癌患者中呈异常高水平表达,与TNM分期具有显著相关性。同时联合检测能显著提高肺癌辅助诊断的灵敏度和阳性率,能够弥补单项检测的不足,为优化治疗方案提供依据。Objective To evaluate the application value of NSE,CYfra21-1,CA125,CA199,CEA and serum lactate dehydrogenase（LDH）in the auxiliary diagnosis of lung cancer.Methods The levels of six kinds of serum were detected in 292 cases of lung cancer patients,201 cases of benign lung disease and 215 individuals of healthy physical examination,by using electrochemical luminescence and enzymatic methods.Results Six levels of serum tumor marker in patients with lung cancer were significantly higher than those in lung benign disease and individuals of healthy physical examination（P〈0.05）;The levels of CYfra211 and CA199 in the male group was significantly higher than female,the positive rate of CYfra211 in squamous cell carcinoma was higher than adenocarcinoma;The results of NSE and LDH in small cell lung cancer were obviously higher than those in non-small cell lung cancer and the positive rate was significantly higher than that of adenocarcinoma,but the results of CA199 and CEA are significantly lower than those in non-small cell lung cancer;The results of CEA and LDH are significant difference between adenocarcinoma and squamous cell carcinomas;While the ascending range of each serum marker had positive correlation with lung cancer TNM staging;The sensitivity and accuracy of combined detection was significantly higher than individual test.Conclusion The six kinds of serum tumor markers are abnormally high levels in patients with lung cancer,and has positive correlation with lung cancer TNM staging.The combined detection of serum markers can significantly improve the detection sensitivity and positive rate in the auxiliary diagnosis of lung cancer,and make up for the shortage of the single detection to provide the basis for optimization of treatment.

关 键 词：肿瘤标志物 肺癌 辅助诊断 

分 类 号：R734.2[医药卫生—肿瘤]