血清糖链抗原CA242与其他肺癌标志物联合检测对肺癌的？…

探讨血清糖链抗原ＣＡ２４２、组织多肽抗原（ＴＰＡ）、神经元特异烯纯化酶（ＮＳＥ）、及癌胚抗原（ＣＥＡ）联合测定对肺癌的诊断价值。方法应用酶联免疫法（ＥＬＳＡ）对１２０例肺癌、３１例肺结核及３０名健康人血清进行观察。结果（１）４项指标在不同组织类型肺癌中均有不同程度升高且明显高于肺结核组及健康对照组。，（２）ＣＡ２４２对肺癌的敏感性分别为腺癌（ＡＣ）６５％、鳞癌（Ｓｐ）４１％及小细胞肺癌（ＳＣＬＣ）     

多指标联合检测对肺癌诊断价值的探讨

采用酶联免疫法对９４例原发性肺癌患者进行了血清糖链抗原（ＣＡ２４２）、组织多肽抗原（ＴＰＡ）、神经元特异性烯醇化酶（ＮＳＥ）和癌胚抗原（ＣＥＡ）４项肿瘤标志物测定。结果提示：肺癌组４项指标均明显高于结核组及正常组；四项指标对不同组织类型肺癌均有一定的诊断价值，但多项指标联合检测有明显的互补性，可显著提高肺癌诊断的敏感性及特异性，并为患者的分型、分期及预后提供可靠依据。     

支气管肺泡灌洗液癌胚抗原和糖链抗原50检测在肺癌诊断中的价值

本文对１８３例支气管肺泡灌洗液（ＢＡＬＦ）的癌胚抗原（ＣＥＡ）和糖链抗原５０（ＣＡ５０）浓度进行了检测。结果显示：肺癌ＢＡＬＦ的ＣＥＡ和ＣＡ５０浓度均值分别为２２．０５±２２．３３μｇ／Ｌ和４１．５３±２９．５７ＫＵ／Ｌ，明显高于肺结核组和肺炎组，Ｐ值均＜０．００１。将ＢＡＬＦ的ＣＥＡ、ＣＡ５０的诊断界值定为≥１０μｇ／Ｌ和２０ＫＵ／Ｌ为阳性，则ＣＥＡ和ＣＡ５０同时阳性对肺癌的特异性为９０％，阳性准确率为９４％。提示ＢＡＬＦ的ＣＥＡ、ＣＡ５０同时检测，可为肺癌诊断提供重要线索。     

快速酶联免疫吸附法检测血清脂阿拉伯甘露糖—IgG对肺结核的…

目的评估脂阿拉伯甘露糖－ＩｇＧ（ＬＡＭ－ＩｇＧ）检测对活动性肺结核的诊断价值，方法采用快速酶联免疫吸附法（ＥＬＩＳＡ）检测９０例肺结核，５３例肺癌患者及３０例正常人血清中的ＬＡＭ－ＩｇＧ。结果，肺结核组ＬＡＭ－ＩｇＧ阳性率为８２％，其中痰结核杆菌除（＋）培（＋）组达９６％，涂（－）培养（－）组为６９％，肺癌组４例阳性，正常组１例阳性，假阳性率分别为８％和３％，结论，提示血清ＬＡＭ－ＩｇＧ测量是肺结     

快速ELISA法检测血清LAM—IgG对肺结核诊断价值的观察

本文采用快速ＥＬＩＳＡ法检测了肺结核、肺癌和健康人血清中ＬＡＭ－ＩｇＧ，以观察其在结核病诊断的吉核组阳性率８２．２％，涂培组阳率９６．４％，涂培组则为６８．６％，而肺癌组及健康组假阳性率各为７．５％、３．４％。结果提示血清中ＬＡＭ－ＩｇＧ检测对活动性肺结核有辅助诊断意义。     

胸腔积液NSE对小细胞肺癌胸膜炎的诊断价值

用放射免疫法测定了７３例胸腔积液患者的血清和胸腔积液的神经元特异性炮醇化酶（ＮＳＥ）水平。结果表明，小细胞肺癌（ＳＣＬＣ）血清ＮＳＥ与胸腔积液ＮＳＥ呈正相关，ＳＣＬＣ胸腔积液ＮＳＥ显著高于非小细胞肺癌（ＮＳＣＬＣ）胸腔积液及结核性胸腔积液的ＮＳＥ水平（Ｐ〈０．０１，Ｐ〈０．０１）。认为ＮＳＥ是诊断ＳＣＬＣ胸腔积液有价值的指标。     

5种标志物对癌性胸液的诊断价值

测定４８例癌性胸液和３３例良性胸液中癌胚抗原（ＣＥＡ）、糖链抗原５０（ＣＡ５０）、α－抗胰蛋白酶（α－ＡＴ）、唾液酸（ＳＡ）及铁蛋白（Ｆｒ）含量，评价其鉴别诊断价值。结果：①癌性胸液组ＣＥＡ、ＣＡ５０水平显著高于良性胸液组（Ｐ＜００１），分别以大于１０μｇ／Ｌ和１２ｋＵ／Ｌ为阳性界值，ＣＥＡ和ＣＡ５０对癌性胸液的诊断敏感性分别为７７１％和６６７％，特异性均为９７％。②ＣＥＡ、ＣＡ５０在癌性胸液中分布无显著相关性（ρ＜０４，Ｐ＞００５），可以互补。两指标联合测定建立判断函数，对癌性胸液的诊断敏感性、特异性和准确率分别为７５％、１００％和８４２％。③α－ＡＴ、ＳＡ、Ｆｒ在癌性胸液和良性胸液中含量无显著性差异（Ｐ＞００５），无鉴别诊断价值     

糖脂抗原和包膜抗原血清学检测活动性结核IgG抗体价值评估

目的评估脂阿拉伯甘露糖─ＩｇＧ（ＬＡＭ－ＩｇＧ）和包膜蛋白─ＩｇＧ对活动性结核的诊断价值。方法两种抗原分别采用快速和常规酶朕免疫吸附法（ＥＬＩＳＡ）进行检测。选择１０８例活动性结核（其中９７例活动性肺结核、１１例肺外结核），６９例非结核肺部疾患（其中肺癌１６例，其它肺部疾患５３例）血清平行检测结核分支杆菌ＩｇＧ抗体。结果９７例活动性肺结核涂阳敏感性分别为７１．８％（２８／３９）和９２．３％（３６／３９），涂阴为６０．３％（３５／５８）和７７．６％（４５／５８）。６９例非结核肺部疾患组两法阳性分别为４例和１４例，假阳性率分别为５．８％（４／６９）和２０．３％（１４／６９）；特异性分别为９４．２％（６５／６９）和７９．７％（５５／６９）。结论提示快速ＥＬＩＳＡ血清ＬＡＭ－ＩｇＧ测定操作简便、快速、不需任何仪器设备且特异性较高，对活动性结核病有较高的临床辅助诊断价值。     

自身免疫性肝炎特异性靶抗原的表达及免疫学鉴定

目的 克隆、表达可溶性肝抗原（ＳＬＡ）及细胞色素Ｐ４５０ ２Ｄ６（ＣＹＰ ２Ｄ６）。方法 采用 ＲＴ—ＰＣＲ技术从人肝组织ｐｏｌｙ（Ａ）＋ＲＮＡ中扩增ＳＬＡ及 ＣＹＰ ２Ｄ６ ｃＤＮＡ，经ＢａｍＨ　Ⅰ、Ｈｉｎｄ Ⅲ双酶切定向插入载体ＰＱＥ－３０并在大肠杆菌Ｍ１５中表达。对表达载体ＰＱＥ—３０／ＳＬＡ、ＰＱＥ—３０／ＣＹＰ ２Ｄ６中的目的基因进行序列分析，表达产物用 ＳＤＳ—ＰＡＧＥ、免疫印迹方法鉴定。结果 表达产物经 ＳＤＳ－ＰＡＣＥ和免疫印迹分析后在分子量 ４．７ × １０４和５．０ × １０４处各有一条明显的蛋白带，并分别能特异性与抗ＳＬＡ、ＣＹＰ２Ｄ６阳性血清反应。结论 表达ＳＬＡ、ＣＹＰ２Ｄ６为自身免疫性肝炎的诊断及其发病机制研究提供物质基础。     

四种肿瘤标记物对肺癌诊断价值的探讨

四种肿瘤标记物对肺癌诊断价值的探讨王耀王光杰顾国浩陶敏国内外一些报道曾提到神经原特异性烯醇化酶（ＮＳＥ），水溶性细胞角质蛋白１９片段（ＣＹＦＲＡ２１１）癌胚抗原（ＣＥＡ）及胃肠道癌抗原（ＣＡ１９９）在诊断肺癌中的意义。现就这四种肿瘤标记物对肺癌的...     

血清肿瘤标记物检测在肺癌诊断中的应用价值

目的探讨血清肿瘤标记物癌胚抗原（CEA）、神经元特异烯醇化酶（NSE）、细胞角蛋白19片段（CYFRA21-1）、组织多肽抗原（TPA）、癌抗原153（CA153）以及癌抗原242（CA242）在肺癌临床诊断中的应用价值。方法采用电化学发光法（ECLIA）分别对肺癌组、肺部良性疾病组患者及健康人的血清肿瘤标记物浓度进行检测分析。结果肺癌组患者6种血清肿瘤标记物浓度均显著高于肺部良性疾病组和健康对照组患者（P〈0．05）;其中在不同病理类型肺癌患者血清中的CEA、NSE及CYFRA21-1水平总体比较,差异有统计学意义（P〈0．05）,各血清肿瘤标记物单独检测灵敏度较低,进行联合检测灵敏度则可大大提高。结论血清肿瘤标记物的联合检测可显著提高肺癌检测的特异性、敏感性。同时可为肺癌临床分期及病理类型的鉴别提供重要参考。     

Prognostic value of serum tumor markers in patients with lung cancer

BACKGROUND: The role of tumor markers in the diagnosis and prognosis of lung cancer is under investigation. OBJECTIVES: The aim of this study was to investigate the diagnostic and prognostic significance of pre-therapeutic levels of various serum tumor markers, CYFRA 21-1, neuron-specific enolase (NSE), tissue polypeptide antigen (TPA), carcinoembryonic antigen (CEA), CA 125 and squamous cell carcinoma antigen (SCCAg), in patients with lung cancer. METHODS: We studied 102 consecutive patients (mean age 65.2 +/- 11 years) with newly diagnosed lung cancer (96 males, 94%, with a mean age of 66.3 +/-10.5 years). All patients had a 5-year follow-up. Measurements of the serum tumor markers were performed on initial diagnosis. RESULTS: Eighty-four patients (82%) had non-small-cell lung cancer (NSCLC) and 18 (18%) small-cell lung cancer (SCLC). From the 84 patients with NSCLC, 34 patients (33%) had squamous-cell lung cancer, 23 (22%) adenocarcinoma and 23 (22%) large-cell carcinomas. The overall median survival was 8.5 months. All SCLC patients had extensive disease with a median survival of 10.1 months and NSCLC patients of 8.4 months. Significant differences in the mean values of NSE and CYFRA 21-1 were observed between SCLC and NSCLC. In NSCLC, CYFRA 21-1, TPA, CA 125 and SCCAg serum levels were related to the stage of the disease at diagnosis, and CYFRA 21-1, NSE, TPA and CA-125 were related to a poor outcome. None of the above tumor markers was related to survival in the SCLC group. CONCLUSION: CYFRA 21-1 and NSE may help to differentiate cell types in lung cancer patients. Also, CYFRA 21-1 with TPA and CA 125 may provide useful information regarding the staging of the disease at diagnosis and the prognosis of patients with NSCLC.     

多肿瘤标志物蛋白芯片检测技术对肺癌的诊断价值分析

目的研究多肿瘤标志物蛋白芯片检测技术对肺部恶性肿瘤的诊断价值。方法同期住院患者分为三组：肺癌组（78例）、肺部良性病变组（118例）、对照组（68例），用多肿瘤标志物蛋白芯片检测系统测定血清中12种肿瘤标志物的水平。结果癌胚抗原（CEA）、糖原125（CAl25）、铁蛋白（Fer）和糖原242（CA242）的血清水平肺癌组明显高于肺部良性病变组和对照组。CEA、CAl25、Fer和CA242检测诊断肺癌的灵敏度分别为41．O％、35．9％、26．9％、17．9％，特异度分别为89．8％、86．0％、86．6％、95．7％。12种肿瘤标志物中单项检测阳性诊断肺癌的敏感度和特异度分别为57．7％和72．0％，二项阳性为32．1％和88．7％，三项阳性为24．4％和96．8％，四项阳性为15．4％和98．9％。结论多肿瘤标志物蛋白芯片检测方法对肺癌诊断的阳性率较高，当三项以上同时阳性时虽然敏感度下降，但特异度可高达96．8％，对于初步判断病灶的恶性性质有一定的帮助。     

Diagnostic utility of serum and pleural fluid carcinoembryonic antigen, neuron-specific enolase, and cytokeratin 19 fragments in patients with effusions from primary lung cancer

STUDY OBJECTIVES: To assess the diagnostic values of carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), and cytokeratin 19 fragments (CYFRA 21-1) as markers of pleurisy in primary lung cancer. DESIGN: Prospective case-control study. SETTING: A tertiary university hospital. PATIENTS: Thirty-four patients with lung cancer and 16 patients with tuberculous pleurisy. MEASUREMENTS AND RESULTS: Levels of CEA, NSE, and CYFRA 21-1 were measured by immunoassay in the serum and pleural fluid of patients with lung cancer and of patients with tuberculous pleurisy. Patients with lung cancer were found to have significantly higher serum and pleural fluid levels of CEA and CYFRA 21-1 than patients with tuberculous pleurisy. Using cutoff values of 5 ng/mL, 20 ng/mL, and 3.3 ng/mL for serum CEA, NSE, and CYFRA 21-1, respectively, the sensitivities and specificities of these tumor markers were as follows for differentiating malignant effusion from benign: CEA, 68% and 93%; NSE, 34% and 93%; and CYFRA 21-1, 45% and 100%. Using cutoff values of 5 ng/mL, 20 ng/mL, and 45 ng/mL for pleural fluid, the sensitivities and specificities were as follows: CEA, 82% and 94%; NSE, 36% and 94%; and CYFRA 21-1, 61% and 81%. A combination of pleural fluid CEA and NSE increased sensitivity and specificity. CONCLUSIONS: In the diagnosis of malignant effusion associated with lung cancer, the determinations of CEA and NSE in pleural fluid could enhance diagnostic yield better than those of all three tumor markers.     

四种肿瘤标志物联合检测在肺癌诊断、治疗检测及判断预后的价值

目的探讨血清癌胚抗原(CEA)、细胞角质蛋白(CYFRA21-1)和神经烯醇化酶(NSE)、糖类抗原125(CA125)对肺癌诊断、治疗检测及预后评估的价值。方法采取血清标本46例,其中腺癌14例、鳞癌23例、小细胞癌9例,肺部良性病变32例。结果 CEA、CYFRA21-1、NSE和CA125在肺癌组的敏感性分别为47.83%、47.83%、52.17%和56.52%。其中CEA对腺癌的敏感性为78.57%,CYFRA21-1对鳞癌的敏感性为60.86%,NSE对小细胞癌的敏感性为88.89%,均明显高于肺部良性病变对照组。将4项联合检测,高于4项单检时的敏感性。肺癌组化疗有效者四项水平明显下降,病情稳定和进展四者水平无变化。结论 CEA、CYFRA21-1、NSE分别对腺癌、鳞癌及小细胞癌的诊断有一定的意义。将CEA、CYFRA21-1、NSE和CA125 4项联检可提高肺癌的诊断率,亦可作为肺癌的疗效检测和预后评估方面有价值的指标。     

血清胃泌素释放肽前体对小细胞肺癌的诊断价值

目的 探讨胃泌素释放肽前体（ProGRP）、神经元特异性烯醇化酶（NSE）、癌胚抗原（CEA）和糖链抗原（CA）19-9在小细胞肺癌患者血清中的水平及其对小细胞肺癌的诊断价值.方法 应用酶联免疫吸附法（ELISA）检测30例小细胞肺癌、30例非小细胞肺癌、15例正常健康体检者的血清ProGRP水平,用电化学发光法测定受试者血清NSE、CEA和CA19-9水平.计算以上4种肿瘤标志物在小细胞肺癌中的阳性率,并用ROC曲线比较对小细胞肺癌的诊断价值.结果 小细胞肺癌组血清ProGRP、NSE水平明显高于非小细胞肺癌组和正常健康组（P〈0.01）,血清CEA、CA19-9水平与非小细胞肺癌组和正常健康组比较差异无统计学意义（P〉0.05）,但非小细胞肺癌组血清CEA水平高于正常健康组（P〈0.05）.血清ProGRP、NSE、CEA和CA19-9在小细胞肺癌诊断中的ROC曲线下面积分别为0.959、0.767、0.617和0.570.血清ProGRP和NSE在小细胞肺癌中的灵敏度分别为96.7%和53.3%,特异度分别为96.7%和46.7%.结论 ProGRP 及NSE均可用于小细胞肺癌的诊断,但ProGRP对小细胞肺癌有更高的诊断价值.     

LTA，CEA，NSE，Cyfra 21—1对肺癌诊断价值的探讨

目的 探讨LTA、CEA、NSE和Cyfra21-1对肺癌诊断价值。方法 清晨空腹抽取临床确诊肺癌患者124例、转移性肺癌9例和良性肺部疾病34例患者静脉血7ml,分别用放射免疫法和乳胶凝集试验法,检测血清中上述癌性标志物水平。结果：LTA、CEA、NSE和Cyfra21-1,在肺癌的阳性率分别为60％、8％、31％和43％;特异性分别为88％、100％、84％和97％,CEA和Cyfra21-1较高;阳性率和敏感性组间差异有统计学意义。LTA对肺癌细胞类型和是否手术无诊断意义 结论 LTA对肺癌具有一定的诊断价值,但特异性差于Cyfra21-1;多种癌性标志物同时检测有助提高阳性率。     

Clinical evaluation of combination assay of tumor markers in primary lung cancer patients

Recently, the measurement of tumor markers, particularly for combined measurement, have been reported to be useful for the early diagnosis of cancer. In this study, the authors measured the serum levels of SLX, CA19-9, CA153, CA125, NCC-ST-439, CEA, SCC, NSE, TPA and IAP in 155 patients with primary lung cancer before treatment (76 adenocarcinomas, 40 squamous cell carcinomas, 36 small cell cancers, 3 large cell cancers). Seventy three benign lung disease cases were also studied as controls. The serum levels of CA19-9, CA153, CA125, NCC-ST-439, CEA, NSE and TPA were significantly higher in lung cancer patients than in benign lung disease patients. CA125 and CEA levels in adenocarcinoma, SCC levels in squamous cell carcinoma, NSE levels in small cell cancer and NCC-ST-439 in non-small cell cancer were significantly higher than those of other histological types of cancer. The level of each marker became higher, and was related with advance in stage. The probability of lung cancer was 90% when three markers were positive except for IAP, which was frequently false positive in benign lung disease. In conclusion, the simultaneous, combined measurement of at least three markers, including CEA and/or TPA was considered to be useful for the diagnosis of lung cancer.     

糖链抗原联合检测对肺癌合并胸腔积液的诊断价值

目的 联合检测胸腔积液中糖链抗原CA72-4、CA242、CEA的水平,探讨其对肺癌合并胸腔积液的诊断价值.方法 采用酶联免疫吸附试验法对39例肺癌合并胸腔积液患者和35例良性疾病合并胸腔积液患者的胸腔积液进行CA72-4、CA242、CEA 3项联合检测.根据ROC曲线选择肿瘤标志物的界值,以敏感性、特异性、阳性预测值、阴性预测值及准确率比较其在不同类型胸腔积液中的表达情况.结果 肺癌患者胸腔积液中3项肿瘤标志物的平均水平明显高于良性疾病患者(P<0.05).CA72-4、CA242、CEA的ROC曲线下面积分别为0.703、0.727、0.804.CA72-4对肺癌性胸腔积液诊断的敏感性和特异性分别为64.1%、71.4 0A.CA242对肺癌性胸腔积液诊断的敏感性和特异性分别为59.0%、80.0%.各项肿瘤标志物联合检测时,CA72-4+CEA和CA72-4+CA242+CEA对肺癌合并胸腔积液诊断的敏感性和特异性相同,分别为89.7%、94.3%.均高于其他联合.结论 检测胸腔积液中糖链抗原CA72-4、CA242、CEA的水平对肺癌合并胸腔积液的诊断有一定价值;多项肿瘤标志物联合检测时,敏感性和特异性均较单项检测时高;最佳联合检测为CA72-4+CEA.