肺泡灌洗液中CA724和CA199诊断肺癌的价值研究  

Diagnostic Value of CA724 and CA199 in Bronchoalveolar Lavage Fluid of Lung Cancer

作　　者：孙士芳[1] 陈众博[1] 张筠[1] 丁群力[1] 宋丹军 陈志华 邓在春[1] SUN Shi-fang;CHEN Zhong-bo;ZHANG Yun;DING Qun-li;SONG Dan-jun;CHEN Zhi-hua;DENG Zai-chun(Department of Respiratory Medicine,the Affiliated Hospital of Medical School of Ningbo University,Ningbo 315020,China;Medical School of Ningbo University,Ningbo 315211,China;Department of Emergency Medicine,Ningbo First Hospital,Ningbo 315000,China)

机构地区：[1]宁波大学医学院附属医院呼吸科,浙江省宁波市315020 [2]宁波大学医学院,浙江省宁波市315211 [3]浙江省宁波市第一医院急诊内科,315000

出　　处：《中国全科医学》2018年第6期653-657,共5页Chinese General Practice

基　　金：宁波市科技惠民项目(2016C51019)

摘　　要：背景肺癌是严重威胁人类健康与生命的恶性肿瘤,然而目前存在的最大问题是肺癌患者难以在早期得到诊断和有效治疗。目的探究肺泡灌洗液(BALF)中CA724、CA199诊断肺癌的价值。方法选取2015-06-06至2016-08-19因肺部肿块于宁波大学医学院附属医院住院的符合研究标准的疑似肺癌患者80例。以组织病理学检查为肺癌的诊断金标准,将患者按照组织病理学检查结果分为肺癌组和良性疾病组;肺癌组患者再按照组织学类型分为肺鳞癌亚组、肺腺癌亚组和小细胞肺癌亚组。比较两组患者基本资料及BALF中CA724、CA199水平;比较良性疾病组与肺癌各亚组患者BALF中CA724、CA199水平;分析BALF中CA724、CA199诊断肺癌的价值。结果 80例疑似肺癌患者中,肺癌组49例、良性疾病组31例;肺癌组患者中男性所占比例、吸烟率高于良性疾病组,年龄大于良性疾病组(P<0.05)。肺癌患者组织学类型:肺鳞癌25例、肺腺癌19例、小细胞肺癌5例。肺癌组与良性疾病组患者BALF中CA724、CA199水平比较,差异无统计学意义(P>0.05)。肺鳞癌亚组BALF中CA724、CA199水平较良性疾病组高(P<0.05);小细胞肺癌亚组患者BALF中CA199水平高于良性疾病组(P<0.05)。绘制BALF中CA724、CA199诊断肺鳞癌的受试者工作特征曲线(ROC曲线),结果显示,当BALF中CA724截断值为4.895 U/ml时,BALF中CA724诊断肺鳞癌的ROC曲线下面积(AUC)为0.668[95%CI(0.526,0.811)],灵敏度为0.640,特异度为0.645;当BALF中CA199截断值为465.85 U/ml时,BALF中CA199诊断肺鳞癌的AUC为0.654[95%CI(0.506,0.801)],灵敏度为0.680,特异度为0.645。结论 BALF中CA724、CA199水平分别诊断肺鳞癌的价值较好,而二者联合诊断肺癌的价值是否更好有待进一步研究。Background Lung cancer is a malignant tumor which seriously threatens human health and life.However,the biggest problem facing the patients with lung cancer is that it is difficult to be diagnosed and effectively treated at an early stage.Objective The aim of this study was to assess the diagnostic value of CA724 and CA199 in bronchoalveolar lavage fluid(BALF)of lung cancer.Methods According to the inclusion criteria of this study,we enrolled 80 patients with suspected lung cancer who hospitalized in the Affiliated Hospital of Medical School of Ningbo University from 2015-06-06 to 2016-08-19 due to lung mass.Based on the histopathological results,we divided the patients into the lung cancer group and benign lung disease group.And the lung cancer group was subdivided into lung squamous cell carcinoma,lung adenocarcinoma and small cell lung cancer subgroups according to the histological type.Comparisons were conducted concerning the baseline characteristics,and levels of CA724 and CA199 in BALF between the two groups,as well as levels of CA724 and CA199 in BALF between the three subgroups.Taken histopathological diagnosis as the gold standard,the diagnostic value of CA724 and CA199 in BALF for lung cancer was assessed comparatively.Results Among the 80 cases of suspected lung cancer,49 were found with lung cancer(lung cancer group)and the other 31 without lung cancer(benign lung disease group).Compared with the benign lung disease patients,lung cancer patients were older,and they had higher prevalence of smoking,and the proportion of men among them was higher(P<0.05).Histology classification revealed there were 25 cases of lung squamous cell carcinoma,19 cases of lung adenocarcinoma and 5 cases of small cell lung cancer.There were no significant differences in the levels of CA724 and CA199 in BALF between the lung cancer group and the benign lung disease group(P>0.05).Both lung squamous cell carcinoma subgroup and small cell lung cancer subgroup demonstrated higher levels of CA724 and CA199 in BALF compared with be

关 键 词：肺肿瘤 支气管肺泡灌洗液 CA724 CA199 诊断 

分 类 号：R734.2[医药卫生—肿瘤]