肺癌患者血清和胸水中常用肿瘤标志物的检测

目的探讨肺癌患者血清和胸水中6种肿瘤标志物的检测意义，并选择较理想的肿瘤标志物组合。方法应用ELISA检测120例肺癌患者和90例肺部良性疾病患者血清和胸水中以及50例健康人血清中神经元特异性烯醇化酶（NSE）、胃泌素释放肽前体（pro-GRP）、细胞角质蛋白19（CYFRA21-1）、鳞癌抗原（SCC）、p53抗体和癌胚抗原（CEA）的水平含量。结果肺癌患者血清和胸水6种肿瘤标志物水平均明显高于健康人组和肺部良性疾病组（P〈0．01）。肺部良性疾病组胸水中NSE、CYFRA21—1和CEA的假阳性率较高。血清NSE、pro—GRP在小细胞肺癌中的水平和敏感性明显高于其他类型的肺癌（P〈0．01）；血清CYFRA21-1、SCC在肺鳞癌中的水平和敏感性明显高于其他类型的肺癌（P〈0．01）。6种血清肿瘤标志物经组合后，在特异性下降不大的情况下。敏感性明显高于任一单项肿瘤标志物（P〈0．01）。结论6种肿瘤标志物的检测对于肺癌的辅助诊断有一定的临床意义。血清NSE、pro-GRP可作为联合检测小细胞肺癌的标志物组合；血清CYFRA21-1、SCC可作为联合检测肺鳞癌的标志物组合；血清NSE、CYFRA21-1、CEA可作为联合检测非小细胞肺癌的标志物组合。

Combined Detection of Serum and Pleural Effusion Tumor Markers in the Diagnosis of Lung Cancer

Objectives To evaluate six tumor markers used alone or in combination for the diagnosis of lung cancer.Methods The level of six tumor markers:NSE?pro-GRP?CYFRA21-1?SCC?p53 antibody and CEA were detected by ELISA in 50 healthy adult subjects,120 patients with lung cancer and 90 patients with respiratory infection.Results The level of the six tumor markers in patients with lung cancer was significantly higher than that of healthy subjects and patients with respiratory infection(P<0.01).The positive ratio of NSE?CYFRA21-1?CEA in pleural effusion of patients with respiratory infection was higher than that of serum.The level and the sensitivity of the NSE?pro-GRP in patients with small-cell lung cancer was significantly higher than in those of other subtypes of lung cancer(P<0.01);The level and the sensitivity of the CYFRA21-1?SCC in diagnosing squamous carcinoma was significantly higher than in those of other subtypes of lung cancer(P<0.01).The sensitivity of tumor markers in diagnosing lung cancer was significantly enhanced when the combined detection was used combination(P<0.01).Conclusion The six tumor markers are value of supplementary parameters in diagnosing lung cancer.The combination of NSE and pro-GRP may be used for diagnosing small-cell lung cancer.The combination of CYFRA21-1 and SCC is may used for diagnosing squamous carcinoma.The combination of NSE?CYFRA21-1 and CEA is may used for diagnosing non-small-cell lung cancer.