血清肿瘤标记物在肺癌诊断中的意义

目的 探讨血清肿瘤标记物癌胚抗原（CEA）、肿瘤相关抗原199（CA199）、肿瘤相关抗原125（CA125）、神经特异性烯醇化酶（NSE）水平及联合检测在肺癌诊断中的价值.方法 采用电化学发光法检测174例肺癌患者血清CEA、CA199、CA125和NSE水平,并与99例肺良性病变患者、42例健康体检者作对照,分析血清肿瘤标记物CEA、CA199、CA125和NSE在肺癌诊断中的价值.结果 ①肺癌组患者血清CEA、CA199、CA125和NSE水平明显高于肺良性病变组、健康体检组（P＜0.05）,肺良性病变组与健康体检组比较无显著性差异（P＞0.05）；②CEA、CA199、CA125和NSE诊断肺癌的灵敏度分别为49.13％、17.92％、31.79％、40.46％;4种肿瘤标记物联合检测诊断肺癌的灵敏度高达60.69％,与各个单项检测诊断肺癌的灵敏度比较差异有统计学意义（P＜0.05）；③血清CEA水平对肺腺癌与其他两种病理类型比较有统计学意义（P＜0.05）；血清NSE水平对肺小细胞癌与其他两种病理类型比较有统计学意义（P＜0.05）；血清CA199、CA125水平对3种病理类型比较差异无明显差异（P＞0.05）.结论 血清肿瘤标记物CEA、、NSE水平与肺癌的病理组织学类型相关,CA199、CA125水平与肺癌的病理组织学类型无关,联合检测可作为肺癌早期诊断的辅助手段,有利于临床的早期发现、早期治疗.

Clinical significance of tumor marker in the diagnosis of lung cancer

Objective To investigate the value of serum tumor markers,such as carcinoembryonic antigen （CEA）,tumor associated antigen 199 （CA199）,tumor associated antigen 125 （CA125）,neuron specific enolase （NSE）,and combined detection in the diagnosis of lung cancer.Methods CEA,CA199,CA125 and NSE of 174 patients with lung cancer,detected by electrochemical luminescence method,were compared with 99 patients with Lung benign disease and 42 people from health checkup to analyse of serum tumor markers CEA,CA199,CA125 and NSE in the diagnosis of lung cancer.Results ①In lung cancer group,levels of CEA,CA199,CA125 and NSE were significantly higher than those of benign lung disease group and the healthy group （P〈0.05）.No significant difference was found between the lung benign disease group and healthy group （P〉0.05）.②The sensitivities of CEA,CA199,CA125 and NSE in the diagnosis of lung cancer are 49.13 %,17.92 %,31.79 %,40.46 % respectively.The sensitivity of combined detection in diagnosis of lung cancer,as high as 60.69 %,has a significant difference with each individual detection in diagnosis of lung cancer （P〈0.05）.③The level of serum CEA of lung adenocarcinoma has a significant difference with the other two pathology type （P〈0.05）.The level of serum NSE of small cell lung carcinoma has a significant difference with the other two pathology type （P〈0.05）,no significant difference of serum CA199,CA125 levels in three different pathologic types of difference （P 0.05）.Conclusion The levels of serum tumor markers CEA,NSE are related to pathological types of lung cancer,and he levels of serum tumor markers CA199 CA125 are unrelated to pathological types of lung cancer,The combined detection can be used as an auxiliary means for early diagnosis of lung cancer,and is beneficial for early detection,early treatment .