血清CEA、CYFRA21-1、TPS和IL-33在老年非小细胞肺癌病人中的表达水平及临床意义  

Expression and clinical significance of serum CEA,CYFRA21-1,TPS and IL-33 in elderly pa-tients with non-small cell lung cancer

作　　者：常文龙[1] 赵静[1] 蔡会欣[1] 卢军栋[1] 李宝新[1] 孙吉瑞 张浩[1] CHANG Wen-long;ZHAO Jing;CAI Hui-xin;LU Jun-dong;LIBao-xin;SUN Ji-rui;ZHANG Hao(Department of Endocrine Laboratory,Baoding NO.1 Central Hospital,Baoding 071000,China)

机构地区：[1]保定市第一中心医院内分泌实验室,河北省保定市071000

出　　处：《实用老年医学》2020年第3期241-245,共5页Practical Geriatrics

基　　金：河北省保定市科技计划项目(17ZF001)。

摘　　要：目的探讨癌胚抗原(CEA)、细胞角蛋白19片段抗原(CYFRA)21-1、组织多肽特异性抗原(TPS)和IL-33在老年非小细胞肺癌(NSCLC)病人血清中的表达水平及临床意义。方法选取2017年1月至2018年1月我院收治的150例NSCLC病人为肺癌组,另选同期收治的肺部良性病变病人50例为良性组和健康体检者50例为对照组。检测所有研究对象血清CEA、CYFRA21-1、TPS、IL-33水平并进行组间比较。结果(1)肺癌组血清CEA、CYFRA21-1、TPS、IL-33水平均显著高于良性组与对照组(P<0.01),且良性组血清CEA、CYFRA21-1、TPS、IL-33水平亦均显著高于对照组(P<0.01);肺癌组中不同年龄亚组病人血清CEA、CYFRA21-1、TPS、IL-33水平比较,差异均无统计学意义(P>0.05)。(2)老年肺腺癌病人的血清CEA水平显著高于老年肺鳞癌病人(P<0.01),CYFRA21-1、IL-33水平均显著低于老年肺鳞癌病人(P<0.01);但不同病理分型病人血清TPS水平比较,差异无统计学意义(P>0.05)。(3)老年NSCLC Ⅰ+Ⅱ期者血清CEA、CYFRA21-1、TPS、IL-33水平均显著低于Ⅲ+Ⅳ期者(P<0.01)。(4)有淋巴结转移的老年NSCLC病人血清CEA、CYFRA21-1水平均显著高于无淋巴结转移者(P<0.05);但两者血清TPS、IL-33水平比较,差异均无统计学意义(P>0.05)。(5)4项指标单独检测时,TPS的敏感度(88.00%)、准确度(88.50%)最高;4项指标联合检测时,其敏感度(100.00%)、准确度(94.00%)高于TPS。结论老年NSCLC病人血清CEA、CYFRA21-1、TPS、IL-33浓度与NSCLC的临床分期、病理分型等临床病理参数密切相关,四者联合检测可明显提高NSCLC诊断的敏感度与准确度,可作为NSCLC诊断及病情监测的重要指标。Objective To investigate the expression and clinical significance of serum carcinoembryonic antigen(CEA),cytokeratin 19 fragment antigen(CYFRA)21-1,tissue polypeptide specific antigen(TPS)and interleukin(IL)-33 in the elderly patients with non-small cell lung cancer(NSCLC).Methods From January 2017 to January 2018,150 patients with NSCLC were selected as lung cancer group.Another 50 patients with benign pulmonary lesions admitted in the same period were selected as benign group and 50 healthy people as control group.Serum levels of CEA,CYFRA21-1,TPS and IL-33 were detected and compared between the groups.Results(1)The levels of serum CEA,CYFRA21-1,TPS and IL-33 in lung cancer group were significantly higher than those in benign group and control group(P<0.01),and the levels of serum CEA,CYFRA21-1,TPS and IL-33 in benign group were also significantly higher than those in control group(P<0.01).There was no significant difference in the levels of serum CEA,CYFRA21-1,TPS and IL-33 between the lung cancer subgroup with different age(P>0.05).(2)The level of serum CEA in the elderly patients with lung adenocarcinoma was significantly higher than that in the elderly patients with lung squamous cell carcinoma(P<0.01),and the levels of CYFRA21-1 and IL-33 were significantly lower(P<0.01),but there was no significant difference in serum TPS level among the patients with different pathological types(P>0.05).(3)The serum levels of CEA,CYFRA21-1,TPS and IL-33 in the elderly NSCLC patients at stage Ⅰ+Ⅱ were significantly lower than those at stage Ⅲ+Ⅳ(P<0.05).(4)The levels of serum CEA and CYFRA21-1 in the elderly NSCLC patients with lymph node metastasis were significantly higher than those without lymph node metastasis(P<0.05),but there was no significant difference in serum TPS and IL-33 levels between the two groups(P>0.05).(5)The sensitivity(88.00%)and accuracy(88.50%)of TPS were the highest when the four indexes detected separately,but the sensitivity(100.00%)and accuracy(94.00%)of the four indexes combined detecti

关 键 词：癌胚抗原 细胞角蛋白19片段抗原21-1 组织多肽特异性抗原 白细胞介素-33 非小细胞肺癌 

分 类 号：R734.2[医药卫生—肿瘤]