血清肿瘤标记物在肺癌诊断中的价值

①目的　探讨血清肿瘤标记物TPA、NSE、CA1 5 3、CEA在肺癌临床诊断中的价值。②方法　采用酶联免疫法检测 36例肺癌病人及 2 8例肺良性病变病人血清TPA、NSE、CA1 5 3、CEA的水平。③结果　肺癌组血清4项肿瘤标记物的含量均高于肺良性病变组 (t=1 .992～ 3 .2 71 ,P <0 .0 5、0 .0 1 )。TPA水平以肺鳞癌升高最明显 ,腺癌及小细胞肺癌 (SCLC)次之 ;NSE以SCLC升高更明显 ;CA1 5 3以肺腺癌增高最明显 ,鳞癌及SCLC次之 ;肺癌各组CEA水平均明显升高 (t =2 .792～ 3 .2 71 ,P <0 .0 1 )。TPA、NSE、CA1 5 3、CEA诊断肺癌的特异度分别为89%、96 %、93 %、1 0 0 % ,灵敏度分别为 71 .3 %、2 7.3 %、58.8%、53 .7%。④结论　TPA、CA1 5 3、CEA对非小细胞肺癌 (NSCLC)具有较大的辅助诊断价值 ,NSE、CEA、CA1 5 3对SCLC诊断意义较大 ,联合检测可提高肺癌诊断的灵敏度、特异度。

DIAGNOSTIC VALUE OF SERUM TUMOR MARKERS FOR LUNG CANCER

Objective To appraise the value of tumor markers TPA, NSE, CA15 3 and CEA in the diagnosis of lung cancer. Methods The levels of TPA, NSE, CA15 3 and CEA were measured by ELISA in serum of 36 patients with lung cancer and 28 with benign lung diseases. Results The levels of TPA, NSE, CA15 3 and CEA in cancer patients were significantly higher than that of benign ones ( t=1.992-3.271, P <0.05, 0.01). The rise of TPA was most obviously in squamous cell carcinoma, while adenocarcinoma as well as small cell lung cancer(SCLC) the next. NSE increased in more obvious in SCLC. The increase of CA15 3 was higher in adenocarcinoma , then spuamous cell one and SCLC . The specificity of TPA, NSE, CA15 3 and CEA was 89%, 96%, 93% and 100%; the sensitivity was 71.3%, 27.3%, 58.8% and 53.7%, respectively. Conclusion TPA, CA15 3 and CEA have important diagnostic value for NSCLC, but NSE, CA15 3, CEA for SCLC.A combination of multiple tumor markers may increase the diagnostic specificity and sensitivity of lung cancer.