不同病理组织亚型的Ⅰa期肺腺癌患者术前癌胚抗原（CEA）水平差异探讨

目的:探讨不同病理组织亚型的Ⅰa 期肺腺癌患者术前癌胚抗原（carcinoembryonic antigen,CEA）水平差异。方法:回顾性分析2012年1月至2017年7月在郑州人民医院住院行肺切除及冰冻病理学检查的120例Ⅰa期浸润性肺腺癌患者。根据新分类患者被分为六种主要病理类型（贴壁状为主型、腺泡为主型、乳头状为主型、微乳头状为主型、实性为主型及浸润性黏液腺癌），进行手术之前检测不同病理类型患者血清CEA水平并进行统计分析。结果:120例患者均为Ⅰa期浸润性肺腺癌，其中贴壁状为主型 17例（14.2%），腺泡为主型 21 例（17.5%），乳头状为主型 23 例（19.2%），微乳头状为主型24例（20.0%），实性为主型 18例（15.0%），浸润性黏液腺癌 17 例（14.2%）。各亚型之间，患者性别、年龄、吸烟史、肿瘤直径及发病部位均无差异（P>0.05）。实性为主型患者术前血清CEA水平较其它类型高，差异有统计学意义（P<0.000 1）。结论:术前血清CEA水平可以作为Ⅰa期浸润性肺腺癌患者术前分型的重要参考依据。

Correlation in histological subtypes with preoperative carcinoembryonic antigen level of Ⅰa stage invasive lung adenocarcinoma

Objective:To explore the difference of perioperative CEA level in Ⅰa stage lung adenocarcinoma patients with pathological tissue types.Methods:We reviewed 120 patients with stage Ⅰa lung adenocarcinoma who underwent pneumonectomy and cryopathologic examination treated from January，2012 to July，2017.According to new classication，the patients were divided into six main pathological types(lepidic，acinar，papillary，micropapillary，solid and mucinous predominant).Preoperative serum CEA levels were assessed before operation.Results:All specimen were stage Ⅰa invasive lung adenocarcinoma with 17 cases lepidic (14.2%)，21 cases acinar (17.5%)，23 cases papillary (19.2%)，24 cases micropapillary (20.0%)，18 cases solid (15.0%)，and 17 cases mucinous predominant (14.2%) subtypes.Gender，age，smoker status，diameter of tumor and pathogenic sites were not different（P>0.05）.CEA levels in patients with the solid subtype were higher than those of other histologic subtypes (P<0.000 1).Conclusion:Preoperative serum CEA levels can serve as a reference marker to identify the histologic subtype in stage Ⅰa lung adenocarcinoma.