多项血清肿瘤标志物联合检测在肺癌诊断中的价值

评价多项肿瘤标志物(TM)在肺癌诊断的应用价值,以期设计出简单而有效的TM组合方式,提高肺癌的诊断率.经回顾分析CEA、CYFRA21-1、NSE、SCC、TPS和CA125对253例肺癌(含肺鳞癌、腺癌和小细胞肺癌)患者的诊断灵敏度以及对123例肺部良性疾病和100名正常人群(对照组)中的特异性,根据其表达特性设计多种组合分析方式并评价其应用价值.结果表明,鳞癌、腺癌的NSE、小细胞肺癌的SCC检测结果与肺部良性疾病组无显著性差异(P＞0.05);肺癌组其余各组织类型肺癌TM均明显高于肺部良性疾病组和对照组(P＜0.05).而肺部良性疾病组和对照组之间无显著性差异(P＞0.05).单项TM检测仅对特定类型的肺癌有较高的灵敏度,而对肺癌的总体灵敏度普遍较低.多项TM联合分析虽可提高灵敏度,但对肺部良性疾病的特异性有所下降,其中NSE CYFRA21-1、NSE CYFRA21-1 SCC和CEA NSE CYFRA21-1三种组合,对各种组织类型肺癌都有较高的灵敏度,对良性疾病的特异性也可保持在88%以上,具有较高的实用价值.

The Diagnostic Value of Combined Detection of Tumour Markers for Lung Cancer

To evaluate the dignostic value of several tumour markers(TM) for lung cancer and try to find the simple and efficient test combination of tumor marks, the diagnostic sensitivity and specificity of CEA, CYFRA21-1, NSE, SCC, TPS and CA125 in 253 cases of lung cancer, 123 cases of benign pulmonary diseases and 100 cases of normal controls were reviewed.The TM combinations were designed according to the TM characters, and the applicative value of these combinations was estimated.The serum TM levels in the lung cancer group were significantly higher than those in benign lung diease group and control group(P< 0.05) except for NSE in squamous cell carinoma and adenocarcinoma patients and SCC in small cell lung cancer patient (P>0.05).The sensitivity of the TM combinations was significantly higher than that of an individual TM but the specificity was lower.The sensitivity of the three TM combinations(NSE+CYFRA21-1, NSE+CYFRA2-1+SCC and CEA+NSE+CYFRA21-1) was higher than that of others, and the specificity was over 88%.These three TM combinations may be more sensitive, specific and helpful in the diagnosis of lung cancer.