摘要
目的:探讨术中胸膜腔冲洗液细胞学及癌胚抗原(CEA)联合检测对非小细胞肺癌(NSCLC)胸膜腔微转移的预测价值。方法:对50例肺癌患者进行术中胸膜腔冲洗,检测冲洗液中游离的肿瘤细胞,同时采用电化学免疫发光技术检测冲洗液中CEA的水平。40例肺良性疾病者作为对照。结果:40例肺良性疾病者胸膜腔冲洗液细胞学全部阴性,冲洗液中CEA的浓度均<0.3ng/mL。肺癌组5例(10.0%)患者胸膜腔冲洗液细胞学阳性,冲洗液中CEA水平反而正常。45例胸膜腔冲洗液细胞学阴性的患者中有27例(54.0%)患者胸膜腔冲洗液CEA水平升高。冲洗液CEA水平与患者的病理分期(P=0.019)、淋巴结分期(P<0.01)、T分期(P=0.003)、冲洗液细胞学(P=0.037)及血清CEA水平(P=0.002)密切相关;与患者的年龄、性别及病理组织类型无明显相关性,P>0.05。胸膜腔灌洗液中细胞学及CEA水平对预测NSCLC胸膜腔微转移的敏感性分别为10.0%(5/50)和54.0%(27/50)。两者联合检测的敏感性为64.0%(32/50),显著高于单项检测,P<0.01。结论:采用冲洗液CEA水平预测NSCLC胸膜腔微转移比细胞学检测更有意义,联合检测可以提高NSCLC胸膜腔微转移的阳性率。
OBJECTIVE： To discuss the value of combination detections of intraoperative pleural lavage cytology （PLC） and CEA for forcasting non-small cell lung （NSCLC） cancer pleural micrometastasis. METHODS.. Fifty patients underwent thoracotomy. Pleural lavage fluid was collected and pleural lavage cytology was determined. Lavage carcinoem-bryonic antigen levels were detected by ECLICA assay. The control group include 40 patients with nonmalignant disease. RESULTS.. In the 40 control patients with benign lung disease,all PLC findings were negative,and all lavage CEA levels were less than 0.3 ng/mL. Positive PLC findings were present in 5 （10.0 %） of the NSCLC patients. Twenty-seven patients（54.0%） ,shown elevated lavage CEA levels. Elevated lavage carcinoembryonic antigen levels were significantly related to pathologic stage （P=0. 019）,T status （P=0. 003）,pN status （P 〈0.01）,positive PLC findings （P=0. 037） and elevated serum CEA levels （P=0. 002）. The PLC findings and lavage CEA levels did not appear to be influenced by age,gender and histologic differentiation. The sensitivities of PLC and lavage CEA level for forcasting NSCLC pleural micrometastasis were 10.0% （5/50） and 54.0% （27/50） respectively. The sensitivities of PLC ＋ lavage CEA level was 64.0% （32/50）. The sensitivity of combination detections was obviously significant compared to the single detection （P〈 0.01）. CONCLUSIONS.. An elevated lavage CEA level may be a more usefull marker for pleural micrometastasis than pleural lavage cyttology. Combination detections can improve the positive rate of NSCLC lavage micrometastases.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2012年第21期1643-1646,共4页
Chinese Journal of Cancer Prevention and Treatment
关键词
灌洗
胸膜腔
细胞学
癌胚抗原
癌
非小细胞肺
外科手术
肿瘤转移
irrigation
pleural cavity
cytology
carcinoembryonic antigen
carcinoma, non-small cell lung
surgical pro cedures,operative
neoplasms metastasis
