血清ProGRP、HE4、CA153、CEA和CYFRA21-1联合检测在肺部良恶性疾病中的临床价值

目的 探讨胃泌素释放肽前体(ProGRP)、人附睾蛋白4(HE4)、癌抗原153(CA153)、癌胚抗原(CEA)及细胞角蛋白19片段(CYFRA21-1)肿瘤标志物联合检测在肺部良恶性疾病中的临床诊断价值.方法 采用电化学发光法(ECLIA)和化学发光微粒子免疫法(CMIA)定量对133例肺恶性肿瘤患者,89例肺部良性疾病(如肺部感染,慢性支气管炎,支气管扩张伴感染,慢性阻塞性肺病等)患者,50例健康人群分别进行ProGRP、HE4、CA153、CEA和CYFRA21-1这5项肿瘤标志物(TM)的检测和统计学分析.结果 肺部恶性疾病组血清中ProGRP、HE4、CA153、CEA和CYFRA21-1水平明显高于肺部良性疾病组和健康对照组,差异有统计学意义(P＜0.05);单项检测血清ProGRP、HE4、CA153、CEA和CYFRA21-1灵敏度以HE4最高,为49.62％,特异性以ProGRP、CA153、CEA最高,为97.75％,单项检测的诊断效率以CEA最高,为60.36％,5项血清肿瘤标志物联合检测的灵敏度为67.67％,明显高于任一单项的检测值.结论 血清ProGRP、HE4、CA153、CEA和CYFRA211是肺部疾病检测中较理想的肿瘤标志物,且5项联合检测有助于临床诊断.

Serum ProGRP,HE4, CA153, CEA and CYFRA21-1 Clinical Value of Combined Detection in Lung Benign and Malignant Diseases

Objective To study the application value of the combined detection of tumor markers (TM) such as serum ProGRP,HE4,CA153,CEA and CYFRA21-1 in lung benign and malignant diseases.Methods The serum levels of ProGRP,HE4,CA153,CEA and CYFRA21-1 were determined by ECLIA and CMIA quantitatively in 133 patients with malignant tumor,89 patients with lung benign disease such as lung infection,chronic bronchitis,bronchial dilation,and chronic obstructive pulmonary disease,and 50 healthy controls.The detection results were statistically analysed.Results The serum level of ProGRP,HE4,CA153,CEA and CYFRA21-1 in the lung malignant diseases group were significantly higher than those in the other two groups (P ＜ 0.05).The sensitivity of HE4 detection in the single index detections was highest (49.62％),the specificity of ProGRP,CA153,CEA was highest(97.75％),and the diagnostic efficiency of single detection of CEA was highest (60.36％).The combined detection of five serum tumor markers' sensitivity was 67.67％,which was significantly higher than any single index detection.Conclusion Serum ProGRP,HE4,CA153,CEA and CYFRA21-1 are ideal TM in lung disease,and five TM combined detection is helpful to clinical diagnosis.