支气管肺泡灌洗液细胞染色体与癌胚抗原联合检测对肺癌的诊断价值.pdfVIP

20o8年 1月第3器第 l期 Chinamedicine ． 论著 ． 支气管肺泡灌洗液细胞染色体与癌胚抗原联合 检测对肺癌的诊断价值 林晓 林其昌 陈公平 潘玉凤 刘合锟 【摘要】 目的 探讨支气管肺泡灌洗液中细胞染色体与癌胚抗原(CEA)检测对肺癌的临床诊断价值。 方法 98例肺部疾病患者分为肺癌组52例和良性肺部疾病组46例。应用纤维支气管镜进行支气管肺泡灌 洗，收集其灌洗液进行细胞染色体检测，并应用放射免疫法测定其中CEA含量，最后进行统计学处理。结果 肺癌组支气管肺泡灌洗液细胞染色体检查发现数目异常达90．38％，而良性肺部疾病组细胞染色体异常仅 4．35％，2组阳性率比较有统计学意义(P0．O1)，若同时观察细胞核情况，肺癌组就有92．31％染色体检出异 常，显著高于细胞病理学检查(阳性率仅71．15％，P0．01)，也明显高于CEA检测(阳性率仅57．69％，P 0．01)，同时检查3项指标敏感性达94．23％，特异性为84．78％，诊断准确性为89．80％。结论 检测支气管肺 泡灌洗液中的细胞染色体结构及数目，CEA含量，并结合细胞病理学检查，对诊断及鉴别诊断肺癌有重要的参 考价值，尤其对周围型肺癌的价值更大，临床操作安全、耐受性好，值得临床推广应用。 【关键词】肺癌； 支气管肺泡灌洗液； 染色体；癌胚抗原 【中图分类号】 R 734．2 【文献标识码】 A 【文章编号】 1673-4777(2008)01-0032-03 DiagRoatlc value of combined chromosome examination and carcinoembryonic antigent in the blon-choalveolar lavage flnids for lung cancer Iin‰ D，Un Qichang，Chen Gongping，Pan Yufeng，Liu Hekun．Respiratory department，the Fimt Affiliated Hospital ofFujian Medical University(Fuzhou 350005，China) 【Abstract】 Objective To study the diagnostic value of the chromosome and Carcinoembryonie antigent (CEA)in the Blonchoalveolar Lavage Fluids(BALFs)for lung cancer．Methods Fi two cases were enroled in the lung cancer group．witll 46 of benign lung disease as the control group．Flexible fiberoptic bronehoseopy Was adopted and the BALFs wel~collected in each group．for CEA and chromosome measurement．Results 90．3％ of the chromosomes in BALFs of lung cancer group were abnormal，while the percentage in control group Was 4．4％ only， showing a significant difference．If nucleus Was examined at the Sanle time．92．3％ of the chromosomes in lung cancer group Was abnormal，which was significantly higher than that of the cytopathological examination(71．1％)and CEA (57．7％)．If CEA，chromosome and carcinoma cell exams were jointly applied，94．2％of lung cancer patients would be positive to at le