CAJ | 학술논문

目的：探讨癌胚抗原（carcino－embryonic antigen， CEA）、肿瘤相关抗原（CA－125）、鳞癌相关抗原（SCC－Ag）、神经元特异性烯醇化酶（Neuron－specific enolase， NSE）、细胞角蛋白21－1（CYFRA21－1）肿瘤标志物联合诊断肺癌的应用价值。方法选取在我院门诊就诊的165例肺癌患者，104例良性肺部疾病患者，并选取同期体检的30名健康人作为对照组，对3组患者的血清CEA、 CA－125、 SCC－Ag、 NSE、CYFRA21－1进行对比分析。结果肺癌组患者CEA、 CA－125、 SCC－Ag、 NSE、 CYFRA21－1指标水平明显高于肺部疾病组和对照组，差异有统计学意义（ P＜0．05）。肺癌的诊断中肿瘤标志物单项检测的灵敏度CY－FRA21－1最高为55．15％，特异度SCC－Ag最高为94．43％。而5项联合指标检测的灵敏度较高，为91．24％，特异度相对较低，为63．75％，差异有统计学意义（ P＜0．05）。在不同的肺癌类型单项检测中， SCC－Ag在小细胞肺癌中有较高的价值，而鳞癌和腺癌中具有较高价值的则分别为CEA和CA125。联合多项指标检测中均具有较高的阳性值，差异有统计学意义（ P＜0．05），结论多项肿瘤标志物联合诊断肺癌具有较高的价值，单项肿瘤标志物预测不同的肺癌病理类型有明显的意义。
목적：탐토암배항원（carcino－embryonic antigen， CEA）、종류상관항원（CA－125）、린암상관항원（SCC－Ag）、신경원특이성희순화매（Neuron－specific enolase， NSE）、세포각단백21－1（CYFRA21－1）종류표지물연합진단폐암적응용개치。방법선취재아원문진취진적165례폐암환자，104례량성폐부질병환자，병선취동기체검적30명건강인작위대조조，대3조환자적혈청CEA、 CA－125、 SCC－Ag、 NSE、CYFRA21－1진행대비분석。결과폐암조환자CEA、 CA－125、 SCC－Ag、 NSE、 CYFRA21－1지표수평명현고우폐부질병조화대조조，차이유통계학의의（ P＜0．05）。폐암적진단중종류표지물단항검측적령민도CY－FRA21－1최고위55．15％，특이도SCC－Ag최고위94．43％。이5항연합지표검측적령민도교고，위91．24％，특이도상대교저，위63．75％，차이유통계학의의（ P＜0．05）。재불동적폐암류형단항검측중， SCC－Ag재소세포폐암중유교고적개치，이린암화선암중구유교고개치적칙분별위CEA화CA125。연합다항지표검측중균구유교고적양성치，차이유통계학의의（ P＜0．05），결론다항종류표지물연합진단폐암구유교고적개치，단항종류표지물예측불동적폐암병리류형유명현적의의。
Objective To investigate the application value of combination of multiple tumor markers [ carcinoembryonic antigen ( CEA) , a tumor-associated antigen ( CA-125) , squamous cell carcinoma associated antigen ( SCC-Ag) , neuron-specific enolase ( NSE) , cytokeratin 21-1 ( CY-FRA21-1 ) ] in the diagnosis of lung cancer.Methods A total of 165 patients with lung cancer and 104 patients with benign lung diseases who were treated at our hospital were included in the stud-y.Thirty healthy people who underwent physical checkup at the same time period served as con-trols.The serum levels of CEA, CA-125, SCC-Ag, NSE, CYFRA21-1 were detected in these sub-jects and analyzed after comparison between groups.Results Serum levels of CEA, CA-125, SCC-Ag, NSE, and CYFRA21-1 were significantly higher in lung cancer patients than in patients with benign lung diseases and healthy people and the difference was statistically significant ( P<0.05) .In single tumor marker detection, the sensitivity of CYFRA21-1 was highest, reaching 55.15%, and SCC-Ag had the highest specificity of 94.43%.The sensitivity of combined detection of the five tumor marker had a highest sensitivity of 91.24 % and a relatively lower specificity of 63.75 ( P<0.05 ) .In use of single tumor marker for detection of different types of lung cancer, SCC-Ag had a high value in diagnosis of small cell lung cancer, and high levels of CEA and CA125 indicated squamous cell carcinoma and adenocarcinoma.Combined detection of a number of tumor markers had a high positive value in diagnosis of these diseases.Conclusion Combined detection of multiple tumor markers has a higher value in diagnosis of lung cancer.The individual tumor marker is of significance in prediction of lung cancer of different pathological types.