Twist蛋白、VEGF、CEA、CYFRA21-1、NSE在肺癌患者恶性胸水中的表达和应用

目的：探讨肺癌患者恶性胸水中Twist蛋白、血管内皮生长因子(VEGF)、癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)、神经原特异性烯醇化酶(NSE)的表达及其临床意义。方法采集52例肺癌患者恶性胸腔积液标本,其中腺癌24例,鳞癌16例,小细胞肺癌12例,良性胸腔积液患者45例作为对照。应用酶联免疫吸附试验法和化学发光法检测各指标水平。结果肺癌组恶性胸水中 Twist 蛋白、VEGF、CEA、CYFRA21-1、NSE 的表达均高于良性肺病组(t值分别为8.67、9.11、3.94、5.37、3.10,P值均<0.05)；肺癌组恶性胸水中 Twist 和 VEGF的水平与患者肿瘤病理类型无关(P 值均>0.05),CEA 水平在腺癌中最高,CYFRA21-1水平在鳞癌中最高,NSE水平在小细胞肺癌中最高。Twist 蛋白、VEGF、CEA、CYFRA21-1、NSE 在肺癌恶性胸水中的敏感度分别为78.8%、84.6%、61.5%、46.2%、42.3%,特异度分别为86.7%、88.9%、91.1%、86.7%、77.8%。CEA、CYFRA21-1、NSE在不同肺癌恶性胸水中敏感度不同,联合检测可提高敏感度。结论胸水中 Twist 蛋白、VEGF、CEA、CYFRA21-1、NSE 检测有利于良、恶性胸水的鉴别, Twist蛋白、VEGF水平与肿瘤病理类型无关,CEA、CYFRA21-1、NSE 水平与肿瘤病理类型相关,联合检测可提高诊断的敏感度。

Expression and clinical significance of Twist,VEGF,CEA,CYFRA21-1,NSE in malignant pleural effusion of patients with lung cancer

Objective To investigate the expression and clinical significance of Twist protein, vascular endothelial growth factor (VEGF),carcino-embryonic antigen (CEA),cytokerantin-1 9-fragment (CYFRA2 1-1),neuron-specific enolase (NSE) in lung cancer patients with malignant pleural effusion. Methods The specimens of 52 cases of lung cancer with malignant pleural effusion were gathered, including 24 cases of adenocarcinoma,16 case of squamous cell carcinoma,and 12 cases of small cell lung cancer.45 patients with benign lung diseases were selected as controls.The expressions of markers were detected by enzyme-linked immunosorbent assay and chemical luminescence method.Results The expressions of Twist protein,VEGF,CEA,CYFRA2 1-1 ,NSE in malignant pleural effusion of lung cancer patients were higher than those of patients with benign lung diseases(t=8.67,9.11,3.94,5.37,3.10, respectively,all P <0.05).The expressions of Twist and VEGF in malignant pleural effusion of lung cancer patients were not related to tumor pathologic types(all P >0.05).The CEA level was highest in adenocarcinoma,the CYFRA21-1 level was highest in squamous cell carcinomas,and the NSE level was highest in small cell lung cancer.The sensitivity of Twist protein,VEGF,CEA,CYRA21-1,NSE in
malignant pleural effusion of lung cancer patients was 78.8%,84.6%,61.5%,46.2%,42.3%,the specificity was 86.7%,88.9%,91.1%,86.7%,77.8%.The sensitivity of CEA,CYFRA21-1,NSE was different in malignant pleural effusion of different pathologic types of lung cancer,sensitivity of joint detection was improved.Conclusions Detection of Twist protein,VEGF,CEA,CYFRA2 1-1 and NSE in pleural effusion is of great clinical value in differential diagnosis.The expressions of Twist and VEGF in malignant pleural effusion of lung cancer are not related to tumor pathologic types.The expressions of CEA,CYFRA2 1-1 ,NSE in malignant pleural effusion of lung cancer are related to tumor pathologic types.Joint detection can improve sensitivity of diagnosis.