肺癌患者血清中CK19-2G2和Cyfra21-1的测定及其对肺癌的诊断价值

目的 测定肺癌患者血清中细胞角蛋白19(CK19)降解片段CK19-2G2的浓度,并评价其对肺癌的诊断价值.方法 采用CK19-2G2和Cyfr21-1的检测试剂盒,分别检测104例肺癌患者、7l例肺部炎症患者和105例健康体检者的血清标本,采用Pearson相关分析判断二者的相关性.运用受试者工作特性曲线(ROC)分析CKl9-2G2和Cyfra21-1的检测效能,并确定CK19-2G2诊断肺癌的临界值.比较CK19-2G2和Cyfra21-1诊断肺癌的灵敏度和准确率.结果 肺癌组、肺部炎症组和健康对照组血清CK19-2G2的中位浓度分别为2.87、1.02和0.01 mU/ml,肺癌组显著高于肺部炎症组和健康对照组(均P<0.01).血清CK19-2G2诊断肺癌的灵敏度(72.1%)和准确率(82.9%)均高于Cyfra21-1(分别为41.35%和73.93%,均P<0.05).CK19-2G2与Cyfra21-1的血清浓度呈正相关(r=0.543).在不同病理类型的肺癌中,肺鳞癌患者的CK19-2G2血清浓度(M=8.35)显著高于肺腺癌患者(M=1.81)和小细胞肺癌患者(M=1.65),差异均有统计学意义(P<0.05).结论 CK19-2G2是一种较好的非小细胞肺癌肿瘤标志物,对肺癌的检测性能优于Cyfra21-1,对肺鳞癌的检测可能有更高的特异性.

Detection of serum CK19-2G2 and Cyfra21-1 protein and comparison of their diagnostic value for lung cancer

Objective To evaluate and compare the value of serum CK19-2G2 and Cyfra21-1 in diagnosis of lung cancer. Methods The serum concentration of CK19-2G2 and Cyfra21-1 was detected in 104 patients with lung cancer, 71 with benign lung diseases and 105 healthy volunteers. The value of the two parameters in the diagnosis of lung cancer was evaluated with ROC curve analysis. The mean level of CK19-2G2 in the three groups was compared with that of Cyfra21-1 by Mann-Whitney U test, and the correlation between these two parameters was calculated using Pearson coefficient correlation test. Results The mean serum CK19-2G2 concentration in the lung cancer group was 2.87 mU/ml, significantly higher than that in the group with benign lung diseases ( 1.02 mU/ml) and healthy volunteer group ( 0. 01 mU/ml) ( P = 0.000). The serum concentration of CK19-2G2 was positively correlated with that of Cyfra21-1, with a Pearson coefficient correlation of 0. 543. Furthermore, the mean serum CK19-2G2 level in squamous cell carcinoma group (8.35 mU/ml) was significantly higher than that in the other pathologic groups (P < 0.05). Conclusion CK19-2G2, with a higher specificity, may be a better tumor marker than CK19-2G2 in respect of specificity for non-small cell lung cancer (NSCLC), especially for squamous lung carcinoma, and deserves further study.