血清TPS、NSE、CEA、β2MG水平与小细胞肺癌生物学关系的探讨

目的:探讨血清组织多肽特异性抗原(TPS)、神经元特异烯醇化酶(NSE)、癌胚抗原(CEA)和β2微球蛋白(β2-mG)水平与小细胞肺癌(SCLC)生物学行为的关系及其对肺癌的诊断价值。方法:采用ELISA和免疫放射分析法(IRMA)测定94例小细胞肺癌患者,86例肺良性疾病患者和89例正常对照组4项标志物的水平。结果:小细胞肺癌组血清TPS、NSE水平(437.8±516.6)U/L、(76.8±91.4)μg/L]不但高于肺良性疾病组(143.6±78.7)U/L、(13.3±10.8)μg/L]和正常对照组(98.4±58.9)U/L、(10.1±5.7)μg/L)],P<0.01。CEA和β2-mG水平测定中,SCLC组亦高于良性疾病组和正常对照组(P<0.01),则以TPS、NSE水平为指标诊断SCLC的敏感性、特异性及准确性分别为84.4%、87.8%、83.6%和79.3%、93.7%、88.3%,高于CEA和β2-mG。此外,发生转移的SCLC血清中TPS、NSE水平高于未转移组,转移灶数目越多,则TPS、NSE水平越高。每天吸烟30～40支可达10～24倍,吸烟量与肺癌之间存在着量效关系。结论:血清TPS、NSE、CEA和β2-mG对于小细胞肺癌的早斯诊断有一定的价值,4项联合检测则有明显的互补性,其水平与肺癌转移密切相关。

Relation between the level of TPS, NSE, CEA and β2-mG in the serum and the biological behavior of small cell lung cancer

AIM: To study the relation between the level of tissue polypeptide specific antigen (TPS), neuron-specific enolase (NSE), carcinoembryonic antigen (CEA) and beta(2)-microglobulin (beta(2)-mG) in serum and the biological behavior of lung cancer for the more scientific diagnosis of lung cancer. METHODS: To detect the level of TPS, NSE, CEA and beta(2)-mG in the serum of 94 patients with small cell lung cancer (SCLC), 86 patients with benign pulmonary diseases (BPD) and 89 patients in normal control group, the level of serum were examined by ELISA and immunoradiometric assay. RESULTS: The level of TPS and NSE in the serum of SCLC group (437.8+/-516.6) U/L, (76.8+/-91.4) microg/L] were much higher than those in BPD group (143.6+/-78.7) U/L, (13.3+/-10.8) microg/L] and normal group (98.4+/-58.9) U/L, (10.1+/-5.7) microg/L, P<0.01)], and the level of CEA and beta(2)-mG in the serum of SCLC group were also obviously higher than those in normal group and BPD group (P<0.01). The sensitivity, specificity and accuracy of SCLC'S diagnosis by an indicator of TPS and NSE were 84.4%, 87.8%, 83.6% and 79.3%, 93.7%, 88.3%, respectively, and were much higher than CEA and beta(2)-Mg. In addition, the level of TPS and NSE in the patients' serum with metastatic SCLC were markedly higher than those in the patients with SCLC without metastasis, increased with the number of metastatic focuses. In clinical practice, the possibility of smokers suffering from lung cancer disease is 8 to 10 times higher than that of no-smokers, and 10 to 24 times higher of the people who smoked 30 to 40 cigarettes per day. From this comparison, the amount of smoking was closely related to the occurrence of lung cancer. CONCLUSION: TPS, NSE, CEA and beta(2)-mG in serum are useful for early diagnosis of lung cancer. There is complementarity in the combined detection of the level of TPS, NSE, CEA and beta(2)-MG. Their levels have close correlation with lung cancer, histological grades and lymphoid nodule metastasis.