肿瘤标志物联合检测在肺癌诊断中的价值 - 第三军医大学学报.docVIP

肿瘤标志物联合检测在肺癌诊断中的价值 李海燕1，刘红2 ，王静3，苗丽君4 摘要：目的 研究肺癌患者血清中，肿瘤标志物肿瘤相关抗原125 （CA125）、肿瘤相关抗原153（CA153）、肿瘤相关抗原199（CA199）、癌胚抗原（CEA）、神经特异性烯醇化酶(NSE)、非小细胞肺癌抗原21-1（CYFRA21-1）浓度在肺癌诊断中的价值。方法 选取郑州大学第一附属医院2010年6月至2011年6月体检及入院患者232例血清标本，采用电化学荧光分析法（ECLIA）分析患者血清中6种肿瘤标志物的浓度，并从中选取最佳的组合进行筛检，评价其在肺癌诊断中的价值。结果 对肺癌患者进行单项肿瘤标志物检测，鳞癌组，CA125灵敏度最高，为40.91%；腺癌组CEA、CYFRA21-1灵敏度高，分别为49.06%、48.49%；小细胞肺癌组CEA、CYFRA21-1、NSE灵敏度高，分别为39.13%、26.09%、30.43%；单项检测CEA诊断价值最高，约登指数为0.3572；联合检测CA125+CYFRA21-1+ CEA可以明显提高筛检的灵敏度可达65.14%，特别对于肺腺癌患者，可达90%以上；联合检测CYFRA21-1+ CEA，特异度及约登指数分别为84.91%、0.4271，诊断价值最高。结论 单项检测CEA在诊断肺癌方面价值最高，尤其对于肺腺癌有更高的提示价值；联合检测CA125+CYFRA21-1+ CEA 对于肺癌诊断灵敏度较高，可以作为高危人群或体检筛查的指标；对于影像学支持肺癌但组织细胞学不易确诊的患者，检测患者血清CYFRA21-1+CEA，对于肺癌诊断会有很大的帮助。 关键词：肺癌、肿瘤标志物、癌胚抗原、神经特异性烯醇化酶、肿瘤相关抗原125、肿瘤相关抗原153、肿瘤相关抗原199、、非小细胞肺癌抗原21-1 中图分类号：R 734.2 文献标识码: A Lung cancer markers united detection in the diagnostic value of lung cancer Li Haiyan，Liu Hong2,Wang Jing3,Miao Lijun4.＊Department of Respiratory ,the First Affiliated Hospital, Zhengzhou University; the open Key Clinical Medical Experimental Laboratory of Henan Province, Zhengzhou 450052 Abstract: Objective To research CA125,CA153,CA199,CEA,NSE and CYFRA21-1,in the blood serum the patients who have lung cancer, the concentration of those indexes whether have value in the diagnosis diagnostic of lung cancer. Methods Select in the first affiliated hospital of Zhengzhou University ,from June, 2010, to 2011 in June to accept 232 outpatients and inpatients serum specimens, by the electrochemical fluorescence analysis (ECLIA) analysis in patients with the serum concentration of the 6 tumor markers, and choose the best combination for screening, evaluation in the diagnostic value of the lung cancer. Results Detect in the patients with lung cancer in individual tumor markers, as in the squamous cell group, the sensitivity of CA125 is the highest，is 40.91%; as in the Adenocarcinoma group, the sensitivity of CYFRA21-1 and CEA is high, for 49.06%, 48.49% ,respectively; as in the