癌胚抗原、糖类抗原、CA125、血管生成素、细胞角蛋白19片段及甲胎蛋白检测在肺癌诊断中的临床研究  

The value of tumor markers CEA,CA199,CA125,Ang-2, CYFRA211 and AFP in the diagnosis of lung cancer

作　　者：王玲 申鸿[2] WANG Ling;SHEN Hong(Clinical Laboratory of Xi'an Daxing Hospital,Xi'an 710016)

机构地区：[1]西安大兴医院检验科,西安710016 [2]西安交通大学医院检验科,西安710061

出　　处：《陕西医学杂志》2019年第8期1080-1084,共5页Shaanxi Medical Journal

基　　金：陕西省社会发展攻关项目(2012K19-01)

摘　　要：目的:探讨肿瘤标志物癌胚抗原(CEA)、糖类抗原(CA199)、CA125、血管生成素(Ang-2)、细胞角蛋白19片段(CYFRA211)及甲胎蛋白(AFP)在肺癌诊断中的价值。方法:回顾性分析确诊的74例肺癌(肺癌组)、76例良性病变者(良性组)及同期抽检的70例健康体检者(对照组)临床资料。对各组研究对象血清CEA、CA199、CA125、Ang-2、CYFRA211及AFP水平进行统计学分析。结果:肺癌组CEA、CA199、CA125、Ang-2、CYFRA211、AFP检测水平均明显高于良性组和对照组(P<0.05),但对照组和良性组各指标检测水平间比较差异无统计学意义(P>0.05)。腺癌患者血清CEA、CA199、CA125、AFP检测水平均明显高于鳞癌及小细胞癌患者(P<0.05);小细胞癌患者血清Ang-2显著低于鳞癌及腺癌患者,而鳞癌血清CYFRA211水平明显高于腺癌和小细胞癌(P<0.05)。不同病理分期患者血清CEA、CA199、CA125、Ang-2、CYFRA211、AFP检测水平间比较差异均具有统计学意义(P<0.05),Ⅲ期检测水平明显高于Ⅰ和Ⅱ期,Ⅳ期明显高于Ⅲ期。CA125+CEA+CA199+Ang-2+CYFRA211+AFP 6项指标联合检测敏感性和准确度显著高于CA125+CEA+CA199+Ang-2、CA125+CEA+CA199+Ang-2+CYFRA211联合检测及各指标单项检测(P<0.05),但特异度未出现明显下降(P>0.05)。结论:血清CEA、CA199、CA125、Ang-2、CYFRA211及AFP对肺癌诊断、病理分期及组织学分型均具有重要意义,联合检测可明显提高肺癌诊断敏感性和准确度,但并不影响诊断特异性,因此可减少临床误诊、漏诊率发生。Objective:To investigate the value of carcinoembryonic antigen(CEA),carbohydrate antigen(CA199),CA125,angiopoietin(Ang-2),cytokeratin 19 fragment(CYFRA211) and alpha fetoprotein(AFP) in the diagnosis of lung cancer.Methods:The clinical data of 74 cases of lung cancer(lung cancer group),76 cases of benign lesions(benign group) and 70 healthy subjects(control group) of the same period were analyzed.Serum CEA,CA199,CA125,Ang-2,CYFRA211 and AFP levels were statistically analyzed in each group.Results:The detection levels of CEA,CA199,CA125,Ang-2,CYFRA211 and AFP in lung cancer group were significantly higher than those in benign group and control group(P<0.05).However,there was no significant difference in the detection levels between the control group and the benign group(P>0.05).The serum levels of CEA,CA199,CA125 and AFP in patients with adenocarcinoma were significantly higher than those in squamous cell carcinoma and small cell carcinoma(P<0.05),the serum Ang-2 level of patients with small cell carcinoma was significantly lower than that of squamous cell carcinoma and adenocarcinoma,while the serum CYFRA211 level of squamous cell carcinoma was significantly higher than that of adenocarcinoma and small cell carcinoma(P<0.05). The serum levels of CEA,CA199,CA125,Ang-2,CYFRA211 and AFP in different pathological stages were statistically significant(P<0.05),and the level of phase III detection was significantly higher than that of stage I and II,and stage IV was significantly higher than stage III.The sensitivity and accuracy of the combined detection of CA125+CEA+CA199+Ang-2+CYFRA211+AFP were significantlyhigher than that of CA125+CEA+CA199+Ang-2,CA125+CEA+CA199+Ang-2+CYFRA211 and each indicator(P<0.05),however,the specificity did not decrease significantly(P>0.05).Conclusion: Serum CEA,CA199,CA125,Ang-2,CYFRA211 and AFP have significant significance in the diagnosis,pathological staging and histological classification of lung cancer. Combined detection can significantly improve the sensitivity and accuracy of lung

关 键 词：肺癌 糖类抗原 癌胚抗原 促血管生成素-2 细胞角蛋白19 片段抗原21-1 甲胎蛋白 诊断 

分 类 号：R737.31[医药卫生—肿瘤]