血清糖链抗原CA242与其他肺癌标志物联合检测对肺癌的诊断价值

目的探讨血清糖链抗原ＣＡ２４２、组织多肽抗原（ＴＰＡ）、神经元特异性烯纯化酶（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（ＥＬＩＳＡ）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（Ｓｑ）４１％及小细胞肺癌（ＳＣＬＣ）３２％，特异性为９３％。（３）综合评价肺癌组２项同时阳性者ＡＣ为７９％、Ｓｑ５４％及ＳＣＬＣ６３％，而结核组假阳性率仅为７％，健康组未发现假阳性者。结论４项指标对不同组织类型肺癌均有一定诊断价值，联合测定时可以提高对肺癌的阳性诊断，ＣＡ２４２可作为一项新的肺癌标志物应用。

The diagnostic values of CA242 combining other tumor markers for lung cancer

Objective To investigate the diagnostic values of CA242, TPA, NSE and CEA tumor markers for lung cancer. Methods Using enzymelinked immunosorbent assay(ELISA). The serum levels of four markers in lung cancer, TB patients and normal subjects (NOR) were measured. Results Serum concentrations of CA242, TPA, NSE and CEA were significantly higher in patients with lung cancer than patients with TB and NOR(P<0.01). The sensitivities of CA242 were 65% for adenocarcinoma (AC), 41% for squamous cancer (Sq) and 32% for SCLC, respectively; the specificity was 93%. The sensitivities of NSE were 33%(AC), 41%(Sq) and 71%(SCLC), respectively; the specificity was 97%. The sensitivities of TPA were 65%(AC), 69%(Sq) and 61%(SCLC), respectively; the specificity was 93%. The sensitivities of CEA were 72%(AC), 54%(Sq) and 55%(SCAuthor LC), respectively; the specificity was 93%. Using two tumor markers the positive rates were 79%(AC), 54%(Sq) and 63%(SCLC), respectively; the false positive rates in TB and NOR were 7% and 0%, respectively. Conclusions Assessing several markers can help differentiating various histological type of lung cancer and can increase significantly the sensitivity and specificity. It is clinically more useful than single marker evaluation. CA242 can be used in diagnosis of lung cancer.