摘要
目的研究血清肿瘤标志物癌胚抗原(CEA)、糖类抗原15-3(CA15-3)、神经元特异性烯醇化酶(NSE)和细胞角蛋白19片段(CYFRA21-1)与肺癌临床分期的相关性,并讨论其临床意义。方法病理学或细胞学确诊的肺癌患者166例,病理分类为腺癌81例,鳞癌44例,小细胞癌l4例,腺鳞癌l2例,复合性小细胞癌11例,其他4例;无转移109例,有转移57例。以同期医院体检健康者36例作为正常对照者。用γ放射免疫测定肺癌患者和正常对照者血清CEA、CA15-3、NSE和CYFRA21-1含量,同时比较各期肺癌之间、有无转移之间这些肿瘤标志物表达水平和阳性率,并分析它们之间的相关性。结果肺癌患者的临床分期:Ⅰ期者占10.24%(17/166),Ⅱ期者占7.23%(12/166),Ⅲ期者占36.75%(61/166),Ⅳ期者占45.78%(76/166)。随肺癌分期增加,各肿瘤标志物血清含量呈上升趋势(P<0.05),肺癌分期越晚,肿瘤标志物阳性率越高(P<0.05)。57例(27.67%)肺癌确诊发生转移,转移后肿瘤标志物(CEA、CA15-3和CYFRA21-1)含量明显高于无转移患者(P<0.01)。以对照组和肺癌患者为观察对象,联合检测CEA、CA15-3、NSE和CYFRA21-1含量优于单一检测,其灵敏度(71.93%)提高和假阴性(28.07%)降低,但特异度(97.25%)、假阳性(2.75%)无明显变化。结论检测CEA、CA15-3、NSE和CYFRA21-1含量对肺癌分期和转移有一定临床意义,联合检测优于单项检测。
Objective To study the correlation between serum tumor marker carcinoembryonic antigen（CEA）,carbohydrate antigen 15-3（CA15-3）,neuron-specific enzyme diluted alcohol（NSE）,cytokeratin 19 fragment（CYFRA21-1） and clinical staging of lung cancer,and discuss its clinical significance.Methods One hundred and sixty-six cases of lung cancer was diagnosed by pathology or cytology,including 81 cases of adenocarcinoma,44 cases of squamous cell carcinoma,l4 cases of small cell carcinoma,l2 cases of adenosquamous carcinoma,11 cases of combined small cell carcinoma and 4 cases of other;non metastasis in 109 cases and metastasis in 57 cases.36 cases of health people in health checks in the hospital at same period were as normal controls.Serum CEA,CA15-3,NSE and CYFRA21-1 levels were measured by γ radioimmunoassay in patients with lung cancer and normal controls;and compared with lung cancers staging,metastasis and without metastasis in the expression levels and positive rate of tumor markers,and the correlations were analyzed.Results There was lung cancer of clinical stage,including I stage 10.24%（17/166）,II stage 7.23%（12/166）,III stage 36.75%（61/166） and IV stage 45.78%（76/166）.With the staging of lung cancer increased serum levels of tumor markers（CEA,CA15-3 and CYFRA21-1） were rising trend（P〈0.05）,the later stages of lung cancer,the higher the positive rate of tumor markers（P〈0.05）.Lung cancer metastasis was diagnosed in 57（27.67%） patients,tumor marker levels after the metastasis were significantly higher than those without metastasis（P〈0.01）.The control group and lung cancer patients were observed as the object,the combination tests of CEA,CA15-3,NSE and CYFRA21-1 levels were better than single test,and sensitivity（71.93%） increased,false negative（28.07%） was lower,but specificity（97.25%） and false positive（2.75%） had no significant change.Conclusion The detection of CEA,CA15-3,NSE and CYFRA21-1 levels on the staging of lung cancer and metastasis has some clinical significance,and the cancer markers combined detection is better than single detection.
出处
《临床军医杂志》
CAS
2012年第2期395-398,共4页
Clinical Journal of Medical Officers
