不同标本肿瘤标志物联合检测对肺癌的诊断价值.pdf

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刘大慶,等不同标本肿瘤标志物联合检测对肺癌的诊断价值
不同标本肿瘤标志物联合检测对肺癌的诊断价值
刘大鹰',胡灼君,农天雷2,林敏
Diagnostic value of combined tumor markers assays in diferent samples patients with
lung cancer
LIU Daying, HU Zhuojun, NONG Tianlei", LIN Min
Department of Respiatio; Dear met of Nuclear Medicine, tie eal Hotal o Lihou ty, an x Lihou 545007, Chin
(Abstract] Objective: To evaluate the clinical significance of assaying carcino-embryonic antigen(EA), car
bohydrate antigens(CA125 and CA19-9 ) and Cytokeratin 19 fragment(cyfra21-1) in serum, sputum, broncho
alveolar lavage fluid (BALF)and pleural effusion of patients with lung cancer. Methods: Using the method of che
mi-luminescent enzyme immunoassay with a commercially available enzyme immunoassay kit, 52 cases with lung
cancer and 46 cases with benign lung diseases underwent assay of CEA, CA125, CA199 and CYFRA21-1 in serum
putum, BALF and pleural effusion. Results: Of the 52 cases with lung cancer, the positive percentages of combination
assays of CEA, CA125, CA199 and CYFRA21-1 were as follows: 69. 2% in serum, 90.4%o in sputum, 88.5% in
BALF and 82. 1% in pleural effusion, respectively; But the positive percentages of those with benign lung diseases
were 19.6%, 26. 1%23.9%, 21.7%, respectively. The positive percentages of combination of these tumor markers
assays in patients with lung cancer was significantly higher than in those with nonmalignant respiratory diseases(P<
0.05) Among the 52 patients with lung cancer, the diagnostic sensitivity of combination of these tumor markers assays
in sputum or BALF was significantly higher than those in serum(P=0.01; P=0. 02). Compared with the single ser-
um samples that these tumor markers were measured, the combination of 2 or 3 of these samples could improve th
sensitivity and accurate value in the diagnosis of lung cancer(P<0.05). Conclusion: To assay CEA, CA125, CA199
and CYFRA21-1 in serum, sputum, BALF and pleural effusion was a valuable aid in diagnosis of lung cancer, and
compared with the single serum sample that these tumor markers were measured, the combination of 2 or 3 of these
samples could improve sensitivity and accurate value in the diagnosis of lung cancer.
Key words] lung neoplasm umor markers; serum; sputum; bronchoalveolar Lavage fluid: pleural effusion; diagnosis
Modern Oncology 2012, 20(09): 1838-184
摘要】目的:检测血液、燚液、支气管肺泡灌洗液(BALF)、胸腔积液四种标本中癌胚抗原(CEA)、癌抗原
125(CA125)、癌抗原199(CA199)和细胞角蛋白21-1片段( CYFRA21-1)的浓度,探讨不同标本肿瘤标志
物(TM)联合检测在肺癌诊断中的意义。方法:采用化学发光免疫分析法检测52例肺癌和46例肺部良性病
变患者血液、痰液、BALF、胸腔积液中CEA、CA125、CA199和 CYFRA21-1的浓度。结果;52例肺癌患者血
液、痰液、BALF、胸腔积液中四种TM联合检测的阳性率分别为69.2%、90.4%、8.-5%和82.1%;而46例肺
部良性病变患者的阳性率分别为19.6%、26.1%、23.9%、21.7%。经统计学检验两组间四种标本TM联合检
测阳性率差异有统计学意义(P<0.05)。肺癌组不同标本之间TM联合检测的阳性率差异有统计学意义(P
0.02);炎液和BALF标本TM联合检测较血液临床意义更大(P=0.01;P=0.02)。联合两个或三个标本检
测与单个血液标本检测相比,其差异有统计学意义(P<0.05)。结论:不同标本肿瘤标志物CEA、CA125
CA199和 CYFRA21-1联合检测对肺癌的诊断具有一定的意义。联合不同标本检测四种TM能提高肺癌诊
断的敏感性。
关键词】肺肿瘤;肿瘤标记;生物学;燚;支气管肺泡灌洗液;胸腔积液;诊断
【中图分类号】R734.2【文献标识码)ADOI:10.3969/j.1isa-1672-4992.2012.09.24
〔文章编号】1672-4992-(2012)09-1838-04
收稿归期】2012-02-14
【修回日期】2012-02-29
【基金项目】广西壮族自治区柳州市科技局基金(编号:2009021525
【作者单位】柳州市柳鉄中心医院'呼吸内科;2核医学科,广西柳州545007
【作者简介)刘大鹰(1969-),男,广西柳州人,副主任医师,主要从事呼吸内科工作。F-mail:ly98330@163.com