肺肿瘤%癌胚抗原%抗原,肿瘤相关,碳水化合物%磷酸丙酮酸水合酶%角蛋白
肺腫瘤%癌胚抗原%抗原,腫瘤相關,碳水化閤物%燐痠丙酮痠水閤酶%角蛋白
폐종류%암배항원%항원,종류상관,탄수화합물%린산병동산수합매%각단백
Lung neoplasms%Carcinoembryonic antigen%Antigens,tumor-associated,carbohydrate%Phosphopyruvate hydratase%Keratins
目的 探讨肿瘤标志物CEA、CA125、神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段抗原(CYFRA21-1)联合检测在肺癌中的诊断价值.方法 研究对象为2010年10月至2012年3月的确诊肺癌住院患者138例(男82例,女56例,平均年龄58.6岁),肺良性病变住院患者96例(男56例,女40例,平均年龄51.3岁)；健康体格检查者45名(对照组,男30名,女15名,平均年龄43.9岁).用电化学发光法检测血清CEA、CA125、NSE和CYFRA21-1水平,各指标的组间比较采用单因素方差分析及q检验.按病理类型分组,对鳞状细胞癌[简称鳞癌(66例)]、腺癌(52例)和小细胞肺癌(20例)的肿瘤标志物水平进行比较,计算单项及联合检测对各类型肺癌的诊断效能.结果 肺癌组血清CEA、CA125、NSE、CYFRA21-1水平均高于肺部良性病变组和健康对照组[CEA:(19.99±30.99)、(10.78± 19.77)、(3.25±3.42) μg/L,CA125:(79.70±95.98)、(44.96±44.97)、(20.66±7.13) μg/L,NSE:(35.23±40.22)、(15.31±8.42)、(13.30± 5.65) μg/L,CYFRA21-1:(18.07±43.71)、(8.30±8.83)、(3.13±1.60) μg/L；F=4.481、5.436、4.776和6.002,均P＜0.05].CEA在腺癌中水平较鳞癌和小细胞肺癌高(F=4.932,P＜0.05),NSE在小细胞肺癌中水平较高(F=5.119,P＜0.05),CYFRA21-1在鳞癌中水平较高(F=5.378,P＜0.05).单项肿瘤标志物在肺癌诊断中灵敏度:鳞癌中CYFRA21-1灵敏度最高(78.8％,52/66),腺癌中CEA灵敏度最高(57.7％,30/52),而在小细胞肺癌中NSE灵敏度最高(75.0％,15/20).在联合检测中CEA+CYFRA21-1+ NSE组合对鳞癌诊断灵敏度最高(89.4％,59/66),腺癌诊断中CEA+CA125+NSE组合灵敏度最高(78.8％,41/52),小细胞肺癌中CEA+CYFRA21-1+NSE组合灵敏度最高(80.0％,16/20).结论 CEA、CA125、NSE、CYFRA21-1联合检测对肺癌的诊断有一定的临床价值,不同病理类型肺癌4种肿瘤标志物表达有所不同.
目的 探討腫瘤標誌物CEA、CA125、神經元特異性烯醇化酶(NSE)、細胞角蛋白19片段抗原(CYFRA21-1)聯閤檢測在肺癌中的診斷價值.方法 研究對象為2010年10月至2012年3月的確診肺癌住院患者138例(男82例,女56例,平均年齡58.6歲),肺良性病變住院患者96例(男56例,女40例,平均年齡51.3歲)；健康體格檢查者45名(對照組,男30名,女15名,平均年齡43.9歲).用電化學髮光法檢測血清CEA、CA125、NSE和CYFRA21-1水平,各指標的組間比較採用單因素方差分析及q檢驗.按病理類型分組,對鱗狀細胞癌[簡稱鱗癌(66例)]、腺癌(52例)和小細胞肺癌(20例)的腫瘤標誌物水平進行比較,計算單項及聯閤檢測對各類型肺癌的診斷效能.結果 肺癌組血清CEA、CA125、NSE、CYFRA21-1水平均高于肺部良性病變組和健康對照組[CEA:(19.99±30.99)、(10.78± 19.77)、(3.25±3.42) μg/L,CA125:(79.70±95.98)、(44.96±44.97)、(20.66±7.13) μg/L,NSE:(35.23±40.22)、(15.31±8.42)、(13.30± 5.65) μg/L,CYFRA21-1:(18.07±43.71)、(8.30±8.83)、(3.13±1.60) μg/L；F=4.481、5.436、4.776和6.002,均P＜0.05].CEA在腺癌中水平較鱗癌和小細胞肺癌高(F=4.932,P＜0.05),NSE在小細胞肺癌中水平較高(F=5.119,P＜0.05),CYFRA21-1在鱗癌中水平較高(F=5.378,P＜0.05).單項腫瘤標誌物在肺癌診斷中靈敏度:鱗癌中CYFRA21-1靈敏度最高(78.8％,52/66),腺癌中CEA靈敏度最高(57.7％,30/52),而在小細胞肺癌中NSE靈敏度最高(75.0％,15/20).在聯閤檢測中CEA+CYFRA21-1+ NSE組閤對鱗癌診斷靈敏度最高(89.4％,59/66),腺癌診斷中CEA+CA125+NSE組閤靈敏度最高(78.8％,41/52),小細胞肺癌中CEA+CYFRA21-1+NSE組閤靈敏度最高(80.0％,16/20).結論 CEA、CA125、NSE、CYFRA21-1聯閤檢測對肺癌的診斷有一定的臨床價值,不同病理類型肺癌4種腫瘤標誌物錶達有所不同.
목적 탐토종류표지물CEA、CA125、신경원특이성희순화매(NSE)、세포각단백19편단항원(CYFRA21-1)연합검측재폐암중적진단개치.방법 연구대상위2010년10월지2012년3월적학진폐암주원환자138례(남82례,녀56례,평균년령58.6세),폐량성병변주원환자96례(남56례,녀40례,평균년령51.3세)；건강체격검사자45명(대조조,남30명,녀15명,평균년령43.9세).용전화학발광법검측혈청CEA、CA125、NSE화CYFRA21-1수평,각지표적조간비교채용단인소방차분석급q검험.안병리류형분조,대린상세포암[간칭린암(66례)]、선암(52례)화소세포폐암(20례)적종류표지물수평진행비교,계산단항급연합검측대각류형폐암적진단효능.결과 폐암조혈청CEA、CA125、NSE、CYFRA21-1수평균고우폐부량성병변조화건강대조조[CEA:(19.99±30.99)、(10.78± 19.77)、(3.25±3.42) μg/L,CA125:(79.70±95.98)、(44.96±44.97)、(20.66±7.13) μg/L,NSE:(35.23±40.22)、(15.31±8.42)、(13.30± 5.65) μg/L,CYFRA21-1:(18.07±43.71)、(8.30±8.83)、(3.13±1.60) μg/L；F=4.481、5.436、4.776화6.002,균P＜0.05].CEA재선암중수평교린암화소세포폐암고(F=4.932,P＜0.05),NSE재소세포폐암중수평교고(F=5.119,P＜0.05),CYFRA21-1재린암중수평교고(F=5.378,P＜0.05).단항종류표지물재폐암진단중령민도:린암중CYFRA21-1령민도최고(78.8％,52/66),선암중CEA령민도최고(57.7％,30/52),이재소세포폐암중NSE령민도최고(75.0％,15/20).재연합검측중CEA+CYFRA21-1+ NSE조합대린암진단령민도최고(89.4％,59/66),선암진단중CEA+CA125+NSE조합령민도최고(78.8％,41/52),소세포폐암중CEA+CYFRA21-1+NSE조합령민도최고(80.0％,16/20).결론 CEA、CA125、NSE、CYFRA21-1연합검측대폐암적진단유일정적림상개치,불동병리류형폐암4충종류표지물표체유소불동.
Objective To investigate the diagnostic value of combined detection of serum tumor markers,including CEA,CA125,neuron-specific enolase (NSE) and cytokeratin fragment antigen 21-1 (CYFRA21-1) for lung cancer patients.Methods The subjects involved 138 diagnosed lung cancer patients (82 males,56 females,average age 58.6 years,from October 2010 to March 2012),96 patients with benign lung diseases (56 males,40 females,average age 51.3 years) and 45 healthy adults (30 males,15females,average age 43.9 years).The pathological types of lung cancer consisted of 66 squamous cell carcinoma (SCC),52 adenocarcinoma and 20 small cell lung cancer (SCLC).The serum levels of CEA,CA125,NSE and CYFRA21-1 were measured with electrochemiluminescence immunoassay.The diagnostic efficacy for different pathological types was compared among each single tumor marker and combination of tumor markers.One-way analysis of variance q test were used for statistical analysis.Results The serum levels of CEA,CA125,NSE and CYFRA21-1 in patients with lung cancer were higher than those in patients with benign lung diseases and in healthy subjects (CEA:(19.99±30.99),(10.78±19.77),(3.25±3.42) μg/L;CA125:(79.70±95.98),(44.96±44.97),(20.66±7.13) μg/L; NSE:(35.23±40.22),(15.31±8.42),(13.30±5.65) μg/L; CYFRA21-1:(18.07±43.71),(8.30±8.83),(3.13±1.60) μg/L; F=4.481,5.436,4.776,6.002,all P＜0.05).The highest level of CEA,NSE or CYFRA21-1 were found in adenocarcinoma (F=4.932,P＜0.05),SCLC (F=5.119,P＜0.05) or SCC (F=5.378,P＜0.05),respectively.The highest sensitivity tumor markers for SCC,SCLC and adenocarcinoma were CYFRA21-1 (78.8％,52/66),NSE (75.0％,15/20) and CEA (57.7％,30/52),respectively.In combined detection,the highest sensitivity combinations for SCC,SCLC and adenocarcinoma were CEA+CYFRA21-1+NSE (89.4％,59/66),CEA+CYFRA21-1+NSE (80.0％,16/20) and CEA+CA125+NSE (78.8％,41/52),respectively.Conclusions Combined detection of serum tumor markers is more sensitive for the diagnosis of lung cancer.The expressions of the above four tumor markers is correlated with pathological types of lung cancer.
