CAJ | 학술논문

目的检测痰液中癌胚抗原(CEA)、癌抗原125(CA125)、糖链抗原19-9(CA19-9)和细胞角蛋白21-1片段(CYFRA21-1)的含量,探讨痰液中肿瘤标志物检测在肺癌诊断中的意义.方法采用化学发光免疫分析法检测52例肺癌(肺癌组)和46例肺部良性病变患者(对照组)痰液中CEA、CA125、CA19-9和CYFRA21-1的含量.结果肺癌组痰液中CEA、CA125、CA19-9和CYFBA21-1的含量分别为(27.6±31.2)μg/L、(76.4±65.2)kU/L、(56.1±31.6)kU/L和(25.2±9.1)μg/L;对照组分别为(6.1±7.5)μg/L、(23.7±7.9)kU/L、(17.3±10.2)kU/L和(1.2±1.7)μg/L,两组比较差异均有统计学意义(P<0.01).肺癌组痰液中CEA、CA125、CA19-9和CYFBA21-1的敏感度分别为42.3%(22/52)、46.2%(24/52)、36.5%(19/52)和51.9%(27,52),四种肿瘤标志物单项在肺癌中的敏感度比较差异均无统计学意义(P>0.05).腺癌CEA阳性率高于鳞癌(x2=4.193,P<0.05),CYFRA21-1阳性率低于鳞癌(x2=4.806,P<0.05).Ⅲ期+Ⅳ期肺癌患者CA125的阳性率较Ⅰ期+Ⅱ期高(x2=5.202,P<0.05).痰液中单项肿瘤标志物的检测阳性率不高,含CYFRA21-1的两项、三项、四项检测组合阳性率明显提高(P<O.05).结论检测痰液中肿瘤标志物CEA、CA125、CA19-9和CYFRA21-1对肺癌的诊断具有一定的意义,联合检测痰液肿瘤标志物获得更高的阳性率和准确度,对肺癌的诊断具有较高的实用价值.
목적 검측담액중암배항원(CEA)、암항원125(CA125)、당련항원19-9(CA19-9)화세포각단백21-1편단(CYFRA21-1)적함량,탐토담액중종류표지물검측재폐암진단중적의의.방법 채용화학발광면역분석법검측52례폐암(폐암조)화46례폐부량성병변환자(대조조)담액중CEA、CA125、CA19-9화CYFRA21-1적함량.결과 폐암조담액중CEA、CA125、CA19-9화CYFBA21-1적함량분별위(27.6±31.2)μg/L、(76.4±65.2)kU/L、(56.1±31.6)kU/L화(25.2±9.1)μg/L;대조조분별위(6.1±7.5)μg/L、(23.7±7.9)kU/L、(17.3±10.2)kU/L화(1.2±1.7)μg/L,량조비교차이균유통계학의의(P<0.01).폐암조담액중CEA、CA125、CA19-9화CYFBA21-1적민감도분별위42.3%(22/52)、46.2%(24/52)、36.5%(19/52)화51.9%(27,52),사충종류표지물단항재폐암중적민감도비교차이균무통계학의의(P>0.05).선암CEA양성솔고우린암(x2=4.193,P<0.05),CYFRA21-1양성솔저우린암(x2=4.806,P<0.05).Ⅲ기+Ⅳ기폐암환자CA125적양성솔교Ⅰ기+Ⅱ기고(x2=5.202,P<0.05).담액중단항종류표지물적검측양성솔불고,함CYFRA21-1적량항、삼항、사항검측조합양성솔명현제고(P<O.05).결론 검측담액중종류표지물CEA、CA125、CA19-9화CYFRA21-1대폐암적진단구유일정적의의,연합검측담액종류표지물획득경고적양성솔화준학도,대폐암적진단구유교고적실용개치.
Objective To evaluate the clinical significance of carcinoembryonic antigen (CEA),cancer antigen 125 (CA125),carbohydrate antigen 19-9 (CA19-9) and eytokeratin 21-1 fragment (CYFRA21-1) assays of sputum in patients with lung cancer. Method Fifty-two cases with lung cancer and 46 cases with benign lung diseases underwent detection of CEA ,CA125 ,CA19-9 and CYFRA21-1 in sputum by using the method of chemi-luminescent enzyme immunoassay. Results The levels of CEA,CA125,CA19-9 and CYFRA21-1 in sputum of 52 cases with lung cancer were (27.6±31.2) μg/L, (76.4±65.2)kU/L, (56.1±31.6) kU/L and ( 25.2±9.1 )μg/L respectively. But the levels of those of 46 cases with benign lung diseases were (6.1±7.5)μg/L, (23.7±7.9) kU/L, (17.3±10.2) kU/L and (1.2±1.7)μg/Lrespectively. The levels of these tumor markers in sputum in patients with lung cancer were significantly higher than those in patients with benign lung diseases(P< 0.01 ). The diagnostic sensitivity of CEA,CA125,CA 19-9 and CYFRA21-1 in sputum in 52 cases with lung cancer was 42.3%( 22/52 ), 46.2% (24/52), 36.5%( 19/52 ) and 51.9% (27/52) respectively ( P > 0.05 ). Among the cancer patients, the sensitivity of sputum CEA in patients with adenocareinoma was significantly higher than that in patients with squamons cell carcinoma (X2= 4.193, P < 0.05 ) ; while the sensitivity of sputum CYFRA21-1 in patients with squamous cell carcinoma was significantly higher than that in patients with adenocarcinoma ( X2 = 4.806,P < 0.05 ). The sensitivity of CA125 in advanced lung cancer( Ⅲ +Ⅳ stage) was higher than that in early lung cancer( Ⅰ+Ⅱstage) (X2= 5.202,P < 0.05 ). Compared with the single tumor marker assaying, the combination of CEA,CA 125, CA 19-9 and CYFRA21-1 in sputum could significantly improve the sensitivity and accurate value in the diagnosis of lung cancer (P<0.05). Conclusion To assay CEA,CA125,CA1g-9 and CYFRA21-1 in sputum is valuable in diagnosis of lung cancer, and the combination of CEA,CA125,CA19-9 and CYFRA21-1 in sputum can significantly improve sensitivity and accurate value in the diagnosis of lung cancer.