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(P<0.01).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(P<0.05).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.