肿瘤标志物在肺腺癌诊断中的临床应用  

The Clinical Application of Tumor Markers in the Diagnosis of Lung Adenocarcinoma

作　　者：张珍[1] 白威峰[2] ZHANG Zhen;BAI Weifeng(Department of Medical Laboratory,Bengbu First People’s Hospital,Bengbu 233000,China;Department of Nuclear Medicine,Bengbu First People’s Hospital,Bengbu 233000,China)

机构地区：[1]蚌埠市第一人民医院检验科,安徽蚌埠233000 [2]蚌埠市第一人民医院核医学科,安徽蚌埠233000

出　　处：《标记免疫分析与临床》2022年第1期71-76,共6页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨胸水和血清肿瘤标志物在肺腺癌患者诊断中的应用价值。方法选取本院2016年5月至2021年7月收治的35例肺腺癌伴胸水患者作为肺腺癌组,并选择同期住院的呼吸系统疾病(肺炎、肺感染、慢性阻塞性肺病等)患者35例为对照组,检测两组胸水和血清中肿瘤标志物及生化水平变化。结果(1)肺腺癌组胸水CEA、CA19-9、CA72-4水平及胸水CEA/血清CEA比值均显著高于对照组(P<0.01);(2)肺腺癌组血清CEA、CA19-9、CA72-4水平显著高于对照组,ADA水平与对照组相比显著降低(P<0.01或P<0.05);(3)肺腺癌组胸水CEA、CA72-4、LDH水平均显著高于血清水平(P<0.01);(4)胸水CEA诊断肺腺癌的灵敏度高于胸水CA19-9、CA724及血清CEA、CA19-9、CA724;胸水CEA、CA72-4和LDH的灵敏度显著高于血清CEA、CA72-4和LDH(P<0.01或P<0.05);(5)胸水CEA的AUC最大,诊断效能最好。结论胸水和血清肿瘤标志物检测在肺腺癌患者的诊断中有较好的应用价值,且胸水肿瘤标志物较血清肿瘤标志物有更高的辅助诊断价值。Objective To explore the value of pleural fluid and serum tumor markers in the diagnosis of lung adenocarcinoma.Methods From May,2016 to July,2021,35 cases of lung adenocarcinoma with pleural effusion patients in our hospital were selected as the lung adenocarcinoma group,while 35 patients with diseases of respiratory system(pneumonia,pulmonary infection,and chronic obstructive pulmonary disease,etc.)who were hospitalized during the same period were selected as the control group.Changes in the levels of pleural fluid and serum tumor markers and biochemical in both groups were detected.Results(1)In the lung adenocarcinoma group,hydrothorax CEA,CA19-9 and CA72-4 levels and hydrothorax CEA/serum CEA ratio were significantly higher than the control group(P<0.01);(2)In the lung adenocarcinoma group,serum CEA,CA72-4,CA19-9 levels were significantly higher than the control group,while the level of ADA was significantly lower than that in the control group(P<0.01 or P<0.05);(3)In the lung adenocarcinoma group,hydrothorax CEA,CA72-4 and LDH levels were significantly higher than the serum levels(P<0.01);(4)The sensitivity of CEA in pleural fluid in diagnosis of lung adenocarcinoma was higher than that of CA199 and CA724 in pleural effusion and serum CEA,CA199 and CA724.The sensitivity of CEA,CA72-4 and LDH in pleural fluid was significantly higher than that in serum(P<0.01 or P<0.05);(5)The area under ROC curve of CEA in pleural fluid was the largest and the diagnostic efficiency was the best.Conclusion The detection of pleural effusion and serum tumor markers has a good application value in the diagnosis of lung adenocarcinoma,and tumor markers in pleural effusion have a higher auxiliary diagnostic value than tumor markers in serum.

关 键 词：肺腺癌 胸腔积液 癌胚抗原 敏感性 肿瘤标志物 

分 类 号：R73[医药卫生—肿瘤]