血清五种肿瘤标志物联合检测在肺癌诊断中的意义

目的 联合检测CEA、CA-125、CYFRA21-1、NSE和SCC等5种血清肿瘤标志物水平,探讨其在肺癌临床诊断中的意义。方法 采集112例肺癌患者血清样本,其中48例肺腺癌,33例肺鳞状细胞癌和31例小细胞肺癌;同时采集32例良性患者血清样本为对照组,所有诊断均有组织学证实。用电化学发光法检测血清的CEA、CA-125、CYFRA21-1、NSE水平,用微粒子酶联免疫发光法检测SCC水平。计算灵敏度、特异度和阳性预测值。结果 血清CEA、CA-125、CYFRA21-1、NSE和SCC单项检测的灵敏度为54.46%、67.86%、39.29%、38.39%和28.57%,特异度为93.75%、96.88%、93.75%、87.50%和96.88%。血清五项肿瘤标志物联合检测阳性预测值为92.17%,联合检测灵敏度和特异度分别为94.64%和71.87%。结论 血清CEA、CA-125、CYFRA21-1、NSE和SCC水平联合检测对于肺癌的诊断有临床价值,且联合检测可以提高肺癌诊断的敏感性,提高肺癌的检出率。

The clinic significance of serum combining assay with five tumor markers for lung cancer diagnosis

Objective To investigate the effect of combined detection of serum tumor markers,carcinoenlbryonic antigen（CEA） , carbohydrate antigen 125 （ CA125 ）, cytokeratin fragment 19 （ CYFRA21 - 1 ）, neuron -specific enolase（NSE）, and squamous cell carcinoma antigen（ SCC）,in the clinical diagnosis of lung cancer. Methods 144 blood samples of the subjects were collected, including 48 adenocarcinomas,33 squamous carcinomas and 31 small cell cacinomas of lung cancer patients ;32 blood samples of normal persons as control. All the diagnosis were supported by histology. The serum level of CEA, CA - 125, CYFRA21 - land NSE were detected by electrochemiswy luminescent technique and SCC by microparticle enzyme immunoassay （MEIA） technology. Sensitivities, specificities and positive predictive values were calculated. Results Sensitivities of CEA, CA - 125, CYFRA21 - 1, NSE, and SCC were 54.46% ,67.86% ,39.29% , 38.39% , and 28.57% respectively, while specificities were 93.75% , 96.88% , 93.75% , 87.50% , and 96.88% respectively. The combined detection of positive predictive value of total serum tumor markers was 92.17% ,sensitivity and specificity were 94.64% and 71.87%. Conclusion The combined detection of CEA,CA - 125, CYFRA21 - 1, NSE, and SCC is an effective method in clinical diagnosis of lung cancer that could increase the sensitivity of the diagnosis of lung cancer and the detection rate.