多肿瘤标志物蛋白芯片检测系统在肺癌诊断中的临床评价

目的：探讨应用多肿瘤标志物蛋白芯片检测系统对肺癌的诊断临床价值。方法：临床确诊的肺癌患者117例为肺癌组,非肺癌的其他肿瘤患者507例为对照组。用多肿瘤标志物蛋白芯片检测系统检测癌胚抗原（CEA）、甲胎蛋白（AFP）、癌抗原125（CA125）、癌抗原15-3（CA15-3）、糖链抗原19-9（CA19-9）、糖链抗原242（CA242）、铁蛋白（Ferr）等12种血清肿瘤标志物,临床评价血清肿瘤标志物的组间差异。结果：CEA,Ferr,CA153这三项指标为诊断肺癌的独立相关因素（P〈0.05）,其诊断肺癌的cut-off值分别为0.39,2.06,0.96。基于上述cut-off值水平,CEA诊断肺癌的敏感性、特异性、阳性预告值分别为80.34%,59.12%,31.54%;Ferr诊断肺癌的敏感性、特异性、阳性预告值分别为80.24%,60.32%,30.99%;CA153诊断肺癌的敏感性、特异性、阳性预告值分别为69.57%,53.29%,25.48%。比较三项指标ROC曲线下面积可见,CEA,Ferr对于鉴别肺癌准确性更高。结论：在众多肿瘤标记物中,CEA,Ferr,CA153水平的升高与肺癌发生独立相关,其中CEA与Ferr具有更高的诊断准确性。

Clinical application and the research progress of multiple tumor marker protein chip detection for lung cancer

Objecfive：To investigate the diagnostic value of multi-tumor markers protein biochip detective system in the diagnosis of lung cancer.Methods：One hundred and seventeen patients with lung cancer（lung cancer group）and five hundred and seven patients with other cancer（control group）were studied.Serum CEA,AFP,CA125,CA15-3,CA19-9,CA242,Ferr were measured with the multi-tumor markers protein biochip detective system.The levels of the markers above were compared between the lung cancer group and control group.Those with a P value of 0.1 were entered into a multivariate analysis.Then the receivers operating curve（ROC） was performed to determine the cut-off value of each independent parameter of lung cancer.The diagnostic value of each markers was compared using the area under the curve（AUC）.Results：The levels of CA19-9,CEA,CA242,Ferr,β-HCG,AFP,Free-PSA,PSA,CA125 and CA15-3 in lung cancer group were higher than in control group（P0.01）.Multivariate analysis demonstrated that the CEA,Ferr and CA153 were independent markers of lung cancer.The optimum cut-off values of CEA,Ferr and CA153 were 0.39,2.06,0.96.AUCs were compared by Medcalc@ version 11.4.4.0 and the result indicated that the AUCs of Ferr and CEA were larger than the AUC of CA125（P0.05）.Conclusion：CEA,Ferr and CA153 were independent parameters in the diagnosis of lung cancer.Among them,Ferr and CEA were superior to CA153 in the diagnosis of lung cancer.