肿瘤分子标志物联合动态检测在肺癌中的临床应用

目的 研究肿瘤分子标忐物癌胚抗原（CEA）、糖类抗原（CA125）、细胞角蛋白19片段抗原21-1（CYFRA21-1）、鳞状上皮癌抗原（Scc-Ag）、神经元特异性烯醇化酶（NSE）、胃泌素释放肽前体31-98（Pro-GRP31-98）联合动态检测在肺癌诊断、临床分期、组织学分型及治疗监控中的临床应用价值.方法 对198例肺癌患者（肺癌组）、50例肺部良性病变患者（良性对照组）及50名健康体检者（健康对照组）采用电化学发光法检测血清CEA、CA 125、CYFRA21-1、Scc-Ag、NSE,酶联免疫法检测Pro-GRP31-98水平,分析肿瘤分子标志物与肺部良恶性疾患的相关性.结果 肺癌组患者血清CEA、CA125、CYFRA21-1、Scc-Ag、NSE、Pro-GRP31-98水平与肺部良性病变组及健康对照组比较差异有统计学意义,P＜ 0.01;肺癌高分期（Ⅲ、Ⅳ期）组血清肿瘤分子标志物水平明显高于肺癌低分期（Ⅰ、Ⅱ期）组,治疗前、淋巴结转移组、复发组与治疗后、无转移组、无复发组比较血清肿瘤标志物水平明显增高,组间分别比较差异有统计学意义,均P＜ 0.01;CEA、CA125分别对肺腺癌的阳性榆出率与鳞状细胞癌、小细胞癌比较差异有统计学意义,P＜ 0.01;CYFRA21-1、Scc-Ag分别对肺鳞状细胞癌的阳性检出率与腺癌、小细胞癌比较差异有统计学意义,P＜ 0.01;NSE、Pro-GRP31-98分别对肺小细胞癌的阳性检出率与腺癌、鳞状细胞癌比较差异有统计学意义,P＜ 0.01;CEA联合CA125、CYFRA21-1联合Scc-Ag、NSE联合Pro-GRP31-98检测分别对肺腺癌、鳞状细胞癌、小细胞癌阳性检出率较单项检测比较明显提高,均P＜ 0.01;CEA、CA125、CYFRA21-1、Scc-Ag、NSE、Pro-GRP31-98诊断肺癌的敏感性分别为52.52％、51.01％、48.99％、53.03％、49.49％、50.50％,六项肿瘤标志物联合检测诊断肺癌的敏感性高达96.46％,与各单项检测比较差异有统计学意义（P＜0.01）.结论 肿瘤分子标志物CEA、CA125、CYF

Clinical application of combined detection of tumor molecular markers in lung cancer

Objective To explore the values of combined detection of carcino embryonic antigen （CEA）,carcinoma antigen 125 （CA 125）,cytokerain 19 fragment 21-1 （CYFRA2 1-1）,carcinoma antigen Scc-Ag （Scc-Ag） and neuron specific enolase （NSE） for diagnosis and treatment of lung cancer.Methods The concentrations of CEA,CA125,CYFRA21-1,Scc-Ag and NSE in 198 patients with lung cancer （lung cancer group）,50 with benign pulmonary disease （benign disease group） and 50 healthies （health control group） were detected by electrochemiluminescence immunoassay （ECLIA）.The concentration of Pro-GRP31-98 was detected by enzyme linked immunoassay.Results Six tumor markers in lung cancer group showed significant diffcrence compared with those of benign disease group and health control group （P 〈 0.01）.The concentrations of serum tumor molecular markers were significantly higher in Ⅲ,Ⅳ stage group than those in ,Ⅱ stage group.Before the treatment,the concentrations of serum tumor molecular markers in lymph node metastasis group and lymph node recurrence group were significantly higher than those in no lymph node metastasis group and no lymph node recurrence group after the treatment （P 〈 0.01）.The positive rate of CEA,CA125 in lung adenocarcinoma group,CYFRA21-1 and Scc-Ag in lung squamous cell carcinomas group and NSE and Pro-GRP31-98 in small cell lung carcinoma group were significantly different from the other two kinds of pathological types （P 〈 0.01）.The positive rates of CEA and CA125 combinated detection in lung adenocareinoma,CYFRA21-1 and Scc-Ag combinated detection in lung squamous cell carcinomas,NSE and Pro-GRP31-98 combinated detection in small cell lung carcinoma was significantly higher than the individual detection respectively.The sensitivitv rates of CEA,CA125,CYFRA21-1,Scc-Ag,NSE and Pro-GRP31-98 were 52.52 %,51.01%,48.99 %,53.03 %,49.49 % and 50.50 %,respectively.And the combinated detection sensitivity rate of the six tumor markers was 96.46 %,which significantly h