血清肿瘤标记物、相关抗原及联合检测在肺癌患者诊断中的意义

目的 探讨血清肿瘤标记物、相关抗原的检测及联合检测在肺癌诊断中的实际意义.方法 随机选取98例肺癌患者(肺癌组)和同时期的68例肺良性病变患者(肺良性病变组)及34例健康人群(健康组)为本次研究对象.LTA检测采用乳胶凝集法,血清CYFRA21-1、CEA、NSE抗原的检测分别采用放射免疫分析法,测定各TM的阳性率,计算其特异性和诊断率的准确度.结果 肺癌组4项TM阳性率显著高于肺良性病变组和健康组,且P＜0.05.NSCLC患者的LTA阳性率最高、腺癌患者的CEA阳性率最高、鳞癌患者的CYFRA21-1阳性率最高、SCLC患者的NSE阳性率最高,与其他类型患者相比,差异均具有统计学意义P＜0.05.Ⅰ、Ⅱ期肺癌患者4项血清TM阳性率均明显低于Ⅲ期和Ⅳ期,且P＜0.01;4项TM联合检测肺癌阳性率最高为94.31%,特异性也提高到95.22%,准确度也是最高,且4项联合检测可将肺癌早期诊断率阳性率提高到63.37%.结论 不同血清肿瘤标记物、相关抗原对不同类型肺癌的诊断均有价值;LTA、CYFRA21-1、CEA、NSE的联合检测,能有效提高肺癌的检出率,能对早期肺癌的诊断提供辅助依据.

Significance of Serum Tumor Markers Associated Antigen and Combined Detection in the Diagnosis of Lung Cancer

Objective To study the significance of serum tumor markers associated antigen and combined detection in the diagnosis of lung cancer.Methods 98 cases of lung cancer(lung cancer group),68 patients with lung benign lesions(lung benign disease group) and 34 cases of healthy people(healthy group) were selected,LTA detection used latex agglutination and serum CYFRA21-1,CEA,NSE antigen detection used immunoradiometric analysis respectively,to determine the positive rate of each tumor marker,calculate the specificity and diagnostic accuracy.Results The positive rates of 4 tumor markers in lung cancer group were significantly higher than benign lung disease group and healthy group,and P＜0.05;LTA positive rate in NSCLC was the highest,the positive rate of CEA in patients with adenocarcinoma was up to 81.46%,squamous cell carcinoma CYFRA21-1 positive rate was up to 84.63%,the positive rate of NSE in SCLC patients was up to 82.33%,the difference was statistically significant,P＜0.05;serum positive rates of 4 tumor markers in stageⅠ,Ⅱ lung cancer were significantly lower than stage Ⅲ and Ⅳ lung cancer,P＜0.01;positive rate of combined detection of 4 tumor markers examining lung cancer was 94.31%,specificity increased to 95.22%,accuracy was the highest,and joint detection of 4 tumor markers can improve positive rate of early diagnosis of lung cancer to 63.37%.Conclusion Different tumor markers have value in the diagnosis of different lung cancer,combined detection of LTA,CYFRA21-1,CEA,NSE can effectively improve the detection of lung cancer,and provide basis for the early diagnosis of lung cancer.