CAJ | 학술논문

　　目的探讨血清肿瘤标志物癌胚抗原（CEA）、糖类抗原199（CA199）、鳞状上皮细胞癌抗原（SCC-Ag）、糖类抗原125（CA125）、细胞角蛋白19血清片段抗原21-1（CYFRA21-1）与非小细胞肺癌（NSCLC）患者病理分型以及分期的关系。方法2009年8月至2012年12月住院的90例年龄≥65岁NSCLC患者，全部经组织学诊断确认。应用电化学发光方法检测其血清中5种肿瘤标志物水平。结果血清中5种肿瘤标志物在肺癌患者中表达水平明显高于健康人组（P＜0.05），在不同性别以及不同年龄段患者中的表达水平差异无统计学意义（P＞0.05）。CEA，CA199，CA125在腺癌中的水平明显高于鳞癌（P＜0.05）；SCC-Ag和CYFRA21-1在鳞癌中的水平明显高于腺癌（P＜0.05）。CYFRA21-1和CA125在N2和N3患者中表达水平明显高于N0和N1患者（P＜0.05）。CEA在有远处转移的患者明显高于无转移的患者（P＝0.041）。CEA和SCC-Ag转移部位越多，其表达越高（P＜0.05）。CEA在Ⅳb患者中表达明显高于Ⅰ+Ⅱ+Ⅲ和Ⅳa患者（P＝0.046）。结论 CEA，CA199，CA125对晚期腺癌的诊断价值较高，SCC-Ag和CYFRA21-1是诊断鳞癌有价值的标志物。5种肿瘤标志物表达与性别、年龄无明显相关。CEA与临床分期正相关，高表达预示分期晚，低表达则对分期参考作用小。CEA和SCC-Ag高浓度应高度警惕有无多部位转移。
　　목적탐토혈청종류표지물암배항원（CEA）、당류항원199（CA199）、린상상피세포암항원（SCC-Ag）、당류항원125（CA125）、세포각단백19혈청편단항원21-1（CYFRA21-1）여비소세포폐암（NSCLC）환자병리분형이급분기적관계。방법2009년8월지2012년12월주원적90례년령≥65세NSCLC환자，전부경조직학진단학인。응용전화학발광방법검측기혈청중5충종류표지물수평。결과혈청중5충종류표지물재폐암환자중표체수평명현고우건강인조（P＜0.05），재불동성별이급불동년령단환자중적표체수평차이무통계학의의（P＞0.05）。CEA，CA199，CA125재선암중적수평명현고우린암（P＜0.05）；SCC-Ag화CYFRA21-1재린암중적수평명현고우선암（P＜0.05）。CYFRA21-1화CA125재N2화N3환자중표체수평명현고우N0화N1환자（P＜0.05）。CEA재유원처전이적환자명현고우무전이적환자（P＝0.041）。CEA화SCC-Ag전이부위월다，기표체월고（P＜0.05）。CEA재Ⅳb환자중표체명현고우Ⅰ+Ⅱ+Ⅲ화Ⅳa환자（P＝0.046）。결론 CEA，CA199，CA125대만기선암적진단개치교고，SCC-Ag화CYFRA21-1시진단린암유개치적표지물。5충종류표지물표체여성별、년령무명현상관。CEA여림상분기정상관，고표체예시분기만，저표체칙대분기삼고작용소。CEA화SCC-Ag고농도응고도경척유무다부위전이。
Objective To investigate the relationship of serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199), squamous cell carcinoma antigen (SCC-Ag), carbohydrate antigen 125 (CA125) and cytokeratin fragment antigen 21-1 (CYFRA21-1) with different pathological types and stages of non-small cell lung cancer(NSCLC) in elderly patients. Methods A total of 90 patients with age over 65 years and pathologically identified NSCLC hospitalized in our department from August 2009 to December 2012 were subjected in this study. Electrochemiluminescence method was applied to detect the expression of above-mentioned 5 serum tumor markers in these patients. Results The expression levels of the five serum tumor markers were significantly higher in the cohort than in healthy volunteers (P<0.05). But no significant difference was found in the levels between different genders, or among those of different age groups (P>0.05). The levels of CEA, CA199, and CA125 were significantly higher in patients with adenocarcinoma than those of squamous cell cancer (P<0.05), but levels of SCC-Ag and CYFRA21-1 were significantly higher in patients with squamous cell cancer than in those of adenocarcinoma. (P<0.05). The expression of CYFRA21-1 and CA125 was significantly higher in the patients at N2 and N3 stages than those at N0 and N1 stages (P<0.05). Furthermore, serum level of CEA was obviously higher in the patients with distant metastasis than those without (P=0.041). The serum levels of CEA and SCC-Ag were increased along with more metastases the patients had (P<0.05). And the expression of CEA was remarkably higher in those at the stage of Ⅳb than at the stage of Ⅰ, Ⅱ, Ⅲ and Ⅳa (P=0.046). Conclusions Serum tumor markers, CEA, CA199 and CA125 are valuable in the diagnosis of late-stage adenocarcinoma of the lung, and SCC-Ag and CYFRA21-1 are more valuable for the diagnosis of squamous cell carcinoma. There is no correlation of the five tumor markers with gender and age. Serum level of CEA is positively correlated to clinical stages of lung cancer. Namely, high level predicts an advanced stage, but low level contributes little to staging. High levels of CEA and SCC-Ag may indicate multiple metastatic sites.