细胞角蛋白片段19等指标在非小细胞肺癌诊断中的应用

目的　研究胸水和血清细胞角蛋白片段 19(CK - 19)等指标在非小细胞性肺癌 (NSCLC)实验室诊断中的应用价值 .方法　采用ELISA法检测 4 5例NSCLC、5 0例良性肺疾病患者血清和胸水中CK - 19水平 ,30例健康体检者血清CK - 19水平 ,同步测定了乳酸脱氢酶 (LDH)、腺苷脱氨酶 (ADA)、C反应蛋白 (CRP)、癌胚抗原 (CEA)、免疫球蛋白E(IgE)水平 ,进行显著性检验及相关性分析 .结果　NSCLC组血清和胸水中CK - 19、CEA和LDH水平均明显高于良性肺疾病组 (p <0 .0 5 ) ,而血清ADA水平均低于良性肺疾病组和健康对照组 (p <0 .0 5 ) .良性肺疾病组血清和胸水CRP水平明显高于NSCLC组 (p <0 .0 5 ) .胸水中CK - 19水平与血清CK - 19水平高度相关 (NSCLC组r=0 .86 8;良性肺疾病组r=0 .5 4 6 2 ) .胸水和血清CK - 19对肺癌的诊断敏感性、特异性和准确性分别为 93.3%和 71.1%、91.7%和 87.5 %、92 %和 81.6 % .结论　胸水和血清CK - 19检测对NSCLC的诊断是一个较好的指标 ,联合检测相关指标有助于临床诊断

Application of the Detection of CK-19 and Other Assiociated Laboratory Items in the Diagnosis of Non-small Cell Lung Cancer

Objective To detect cytokeratin 19 fragment (CK-19) and other associated biochemical items and analysis their clinical significance for specific diagnosis of Non-small cell lung cancer (NSCLC) in the laboratory. Methods The level of CK-19 in the pleural effusion (PE) and serum of 45 lung cancer patients,50 benign lung disease patients, and the level of CK-19 in the serum of 30 healthy people control were detected by ELISA, and the correlation of these parameters was analysised.Other associated laboratory items including LDH, ADA, CRP, CEA, IgE were assayed in the PE and serum of these patients. Results The level of CK-19,CEA and LDH in the NSCLC group were higher than there in benign lung disease group and healthy control group(p<0.05),but the level of ADA in the cancer group were lower than that in the benign lung disease group and healthy control group(p<0.05).The level of CRP was increased significantly in the benign group(p<0.05).The level of CK-19 in the PE were significantly correlated with that in the serum of patients with lung cancer (r=0.868 ) and patients with benign lung disease(r=0.5462 ).The sensitivity, specificity, and accuracy of CK-19 in the PE and serum as a diagnostic test for NSCLC was 93.3%,71.1%,91.7% and 87.5%,92%, 81.6% respectively. Conclusions Pleural effusion CK-19 may be a useful test for diagnosing NSCLC. It may be more benificial for diagnosing lung cancer measuring the CK-19 and other associated laboratory items combinatorial optimation.