摘要
目的 :为探讨肿瘤标记物CEA、CA5 0、CA199和CA2 42在肺部恶性肿瘤诊断中的意义。方法 :收集2 2 3例病人的血清标本 ,其中肺鳞癌 41例 ,腺癌 46例 ,小细胞肺癌 14例 ,不能分型 16例 ,肺内转移癌 6例 ,肺部良性病变 10 0例。采用放射免疫法检测各指标的血浆水平。经SAS软件包统计学处理 ,用敏感度、特异度、阳性预测值和阴性预测值并比较其在不同病理类型肺癌中的表达情况。结果 :CEA值在小细胞癌、鳞癌、腺癌、不能分型肺癌、肺内转移癌组均明显高于正常值上限 ,而良性病变组的CEA水平与正常人血清水平无显著差异。CA5 0只在肺腺癌组升高明显 ,与正常值有显著性差异。CA199在肺腺癌组、不能分型肺癌组和肺内转移癌组明显高于正常值 ,统计学上有显著性差异。CA2 42只在肺内转移癌轻度升高 ,统计学上有差异。CEA、CA5 0、CA199和CA2 42的特异度分别为 86 %、92 %、94%和 94%。CEA的敏感度分别为肺鳞癌 (31.0 %)、肺腺癌 (5 0 0 %)、不能分型肺癌(5 6 5 %)、肺小细胞癌 (6 0 .0 %)和肺内转移癌 (2 5 0 %)。CA5 0分别为 2 0 .4%、14.3%、2 6 .1%、6 .7%和 33.3%。CA199分别为 :9.7%、2 1.4%、30 .4%、2 0 .0 %和 5 0 .0 %。CA2 42分别为 :14.6 %、2 1.4%、2 6 .1%,2 6 .7%和 5 0 .0 %。
Purpose:Investigate the clinical value of tumor markers CEA, CA50, CA199 and CA242 for the diagnosis of lung cancer.Methods:The 223 serum sample included 41 cases of squamous cell carcinoma, 46 cases of adenocarcinoma, 14 cases of small cell lung cancer, 16 cases of unclassified carcinoma, 6 cases of metastatic carcinoma, 100 cases of benign lung disease. The levels of CEA, CA50, CA199 and CA242 in the plasm were measured by ELISA. Some data were analyzed by t and χ 2 test. The results were analyzed with regard to sensitivity, specificity, negative prognostic value, positive prognostic value and positive percentage.Results:In all malignant groups the value of CEA was higher than normal value,while in benign group. There was notable difference (P<0.001). There were no notable differences between benign group and normal people. CA50,CA199 and CA242 had similar result in adenocarcinoma group and metastatic carcinoma group. The specificity of CEA, CA199, CA50 and CA242 were 86%, 94%, 94% and 94% respectively. The sensitivities of CEA were 31.0% in squamous carcinoma, 50.0% in adenocarcinoma, 56.5% in unclassied lung cancer, 60.0% in small cell lung cancer and 25.0% in metastatic tumor in lung. Those of CA50 were 20.4%, 14.3%, 26.1%, 6.7% and 33.3% respectively in order as above. For CA199 those were 9.7%, 21.4%, 30. 4%, 20.0% and 50.0%,and that of CA242 were 14.6%, 21.4%, 26.1%, 26.7% and 50.0%. In malignant pulmonary disease group, for CEA, CA50, CA199 and CA242 the positive rates were 44.7%, 14.6%, 21.9% and 22.7%; the sensitivity were 44.7%, 14.6%, 21.9% and 22.7%; the specificity were 86.0%, 92.0%, 94.0% and 94.0%. Conclusions:The level of these tumor markers in malignant pulmonary disease was higher than normal. But there were no notable statistic difference between the benign pulmonary disease and the malignant pulmonary disease for the positive rate. The specificity was satisfactory, but the sensitivity was not enough to diagnose malignant pulmonary disease. CEA had close relation to adenocarcinoma and metastatic carcinima in lung. The other tumor markers also had some relationship to malignant pulmonary disease, but the sensitivity was not satisfactory.
出处
《中国癌症杂志》
CAS
CSCD
2001年第6期510-512,共3页
China Oncology
基金
国家重点科技项目 95攻关的资助 ( 96 90 7 0 3 0 3)
