晚期肺癌患者光子刀治疗前后检测肺泡灌洗液、血清中铁蛋白、CA.docVIP

晚期肺癌患者光子刀治疗前后检测肺泡灌洗液、血清中铁蛋白、CA199、CEA的临床意义 　　作者：陈艺坛 作者单位：解放军第92医院呼吸内科，福建南平353000 　　【摘要】 目的探讨支气管肺泡灌洗液(BALF)、血清中铁蛋白(SF)、糖链抗原199(CA199)和癌胚抗原(CEA)测定在晚期肺癌光子刀放疗中的临床意义。方法采用免疫放射分析法(IRMA)测定48例肺癌患者放疗前及放疗后、放疗后3个月、放疗后半年及58例肺良性疾病患者BALF和血清中SF、CA199、CEA的水平。结果肺癌组BALF和血清中SF、CA199、CEA明显高于肺良性疾病组，差异有显著统计学意义(P0.01);肺癌组内BALF的SF、CA199、CEA水平高于血清(P0.01)，而肺良性疾病组各项检测指标间差异无统计学意义(P0.05) ;肺癌组BALF及血清中SF、CA199、CEA在放疗后各期均低于放疗前(P0.01)，各项指标以放疗后3个月内下降较快，其后下降缓慢。结论SF、CA199、CEA与肺癌的病情变化呈负相关，其在肺泡灌洗液中较血清更敏感，对晚期肺癌患者光子刀放疗的病情动态变化、估计预后有一定的参考价值。 　　【关键词】 肺肿瘤 光子刀 支气管肺泡灌洗液 铁蛋白 糖链抗原 癌胚抗原 　　Clinical Value of Determination of SF, CA199 and CEA in Bronchoalveolar Lavage Fluid and Serum on Patients with Terminal Lung Cancer around Photon Knife Radiotherapy 　　Chen Yitan, Pan Yunhu, Chen Zhibin, Huang Fangfang, Liu Yiping 　　Department of Internal Medicine, PLA 92nd Hospital, Nanpin 353000, China 　　Abstract： ObjectiveTo explore the clinical value of the detection of serum ferritin (SF), carbohydrate antigen199 (CA199) and carcinoembryonic antigen (CEA) in bronchoalveolar lavage fluid (BALF) and plasm on terminal lung cancer patients treated by photon knife. MethodsImmunoradiometric assay (IRMA) was utilized to determine SF, CA199 and CEA in 48 patients with teminal lung cancer treated by photon knife (trial group) and in 58 patients with benign lung disease (control group). ResultsThe concentrations of SF, CA199 and CEA in BALF and plasm were significantly higher in the trial group than in the control group (P0.01). In the trial group, each indicatrix of BALF was higher than that of plasm or serum (P0.01). In the trial group, the concentrations of SF, CA199 and CEA at each stage during radiotherapy were significantly lower than that before radiotherapy (P0.01). The indicatrix descent was more obvious within the first three months after radiotherapy. ConclusionSF, CA199 and CEA are negatively correlative with terminal lung cancer patients condition after radiotherapy, especially s