组织多肽抗原联合ProGRP、CEA、NSE、SCC、CYFRA21-1在肺癌诊治中的价值

目的 评估组织多肽抗原（TPA）联合ProGRP、CEA、NSE、SCC、CYFRA21-1在肺癌诊断与疗效监测中的应用价值。方法 用化学发光法和电化学发光法检测238例肺癌患者、25例肺部良性疾病患者及65名健康对照者血清中的TPA、ProGRP、NSE、SCC、CYFRA21-1和CEA水平，并对33例肺癌患者进行随访检测。同时用SPSS19.0统计软件及接受器工作性能曲线（ROC）分析，评价肿瘤标志物的临床应用价值。结果 肺癌患者血清TPA水平（中位数为130.45 U/L）明显高于肺部良性疾病患者（中位数为82.21 U/L）和健康对照组（中位数为70.96 U/L）（P=0.000, 0.002）。根据ROC曲线分析，TPA检测肺癌的临界值为130 U/L，敏感度为50%，特异性为88.9%，相比于其他肺癌标志物( ProGRP、NSE、SCC、CYFRA21-1、CEA），敏感度较高，特异性稍低。肺癌患者血清TPA水平及阳性率随着肿瘤分期的升高而升高（P均<0.05）。TPA水平与疗效也密切相关，临床治疗有效时TPA下降，而病情恶化或出现转移时则升高。各种组合检测中，以六项组合诊断肺癌的敏感度和有效性最高。结论 TPA联合ProGRP、CEA、NSE、SCC、CYFRA21-1测定在肺癌的诊断、疗效及监测复发转移中，具有一定的临床价值。

Evaluation Value of Tissue Polypeptide Antigen Combined with ProGRP,CEA, NSE,SCC and CYFRA21-1 on Patients with Lung Cancer

Objective To evaluate the clinical value of tissue polypeptide antigen(TPA) combined with ProGRP, CEA, NSE, SCC and CYFRA21-1 on patients with lung cancer. Methods TPA, ProGRP, NSE, CEA, CYFRA21-1 and SCC in the serum of 238 lung cancer patients, 25 benign lung diseases patients and 65 healthy controls were determined by chemilumineseent immunoassay(CLIA) and electrochemilumineseent immunoassay(ECLIA). And 33 cases of patients with lung cancer were followed up. SPSS19.0 statistical software and receiver operation characteristic(ROC) were applied to evaluate the clinical application value of tumor markers. Results The level of TPA was significantly higher in lung cancer group[median (130.45 U/L)] than those in benign lung disease group[median (82.21 U/L)] and healthy control group[median (70.96 U/L)] (P=0.000, 0.002, respectively). ROC analysis showed the cut-off value to discriminate cancer from control was established at 130U/L for TPA [sensitivity (50%), specificity (88.9%)]. The sensitivity of TPA was higher than other markers: ProGRP, NSE, CEA, SCC and CYFRA21-1, while the specificity was lower. With the rising of lung carcinoma staging, the levels of TPA as well as the positive rate were increased(P<0.05). Changes of TPA concentrations were correlated with tumor response. Elevated levels of TPA were found in the recurrent or metastasis disease patients, and the levels were decreased while the patients were sensitive to therapy. The sensitivity and effectiveness of the group of six tumor markers were the highest in all combined groups. Conclusion There is specifically clinical application value of these six tumor markers: TPA, ProGRP, NSE, CEA, CYFRA21-1 and SCC, for the diagnosis, curative effect, and prognosis monitoring of lung cancer.