肿瘤相关抗原抗体联合检测在肺癌早期诊断中的价值评价

目的：对肿瘤相关抗原（tumor—associated antigen，TAA）抗体联合检测用于肺癌诊断的价值进行评价。方法：利用酶联免疫吸附试验（ELISA）检测肺癌患者血清和正常血清中8种TAA抗体，并进一步利用流行病学方法对各抗原检测结果进行评价。结果：每种抗原检测结果单独进行判断时，灵敏度都偏低。对8种TAA进行不同的组合，结果随着抗原种类的增多，灵敏度随之增加，8种抗原联合检测的灵敏度达到了64．3％，特异度达到了86．2％，阳性预测值88．7％，阴性预测值58．8％，提示8种抗原组合检测肺癌时大大提高了诊断的质量；阳性似然比4．66，说明8种抗原联合检测肺癌的临床诊断价值较高；kappa值0．46，提示该试验诊断结果与真实值之间中度一致。结论：利用8种TAA抗体联合检测肺癌，具有较高的真实性，为现场高危人群的筛检和临床中肺癌的早期诊断提供了一种新方法。

Evaluation of diagnostic value on lung cancer using a panel of multiple tumor-associated antigens

Objective:To evaluate the diagnostic value of a panel of multiple tumor-associated antigens(TAAs) and antibodies on lung cancer.Methods:The antibodies against eight TAAs in sera from patients with lung cancer and normal human serum were detected by enzyme-linked immunosorbent assay(ELISA).The validity of testing result for each TAA antibody was evaluated by epidemiological method.Results:When results were judged according to any individual TAA,the sensitivities rarely exceeded 20%.With the successive addition of TAAs to a final total of eight antigens,there was a stepwise increase of positive antibody reactions reaching a sensitivity of 64.3% and a specificity of 86.2%.Positive and negative predictive values were 88.7% and 58.8%,respectively.It indicated that parallel assay of eight TAAs raised the diagnostic quality greatly.Positive likelihood ratio was 4.66,which showed that the clinical diagnostic value of parallel assay of eight TAAs was high.Kappa value was 0.46,which indicated the observed value of this assay had midrange coincidence with actual value.Conclusion:This study shows that a panel of eight TAAs can enhance antibody detection for diagnosis of lung cancer,the approach may be used as a screening tool for population at high risk in lung cancer,and also a routine test in clinical practice.