血清多种肿瘤标志物联合检测对肺癌的诊断价值

目的探讨7种血清肿瘤标志物单项和联合检测对肺癌诊断的临床价值。方法检测234例肺癌患者、84例肺良性病变患者和28名健康人血清癌胚抗原（CEA）、糖类抗原125（CA125）、细胞角蛋白19片段（CYFRA211）、神经元特异性烯醇化酶（NSE）、恶性肿瘤生长因子（TSGF）、鳞癌相关抗原（SCC）、组织多肽特异性抗原（TPS）。结果 （1）肺癌患者的7种血清肿瘤标志物水平均明显高于肺良性病变组（均P〈0.05）和健康对照组（均P〈0.01）。（2）肺癌组7种血清肿瘤标志物阳性率均明显高于肺良性病变组（均P〈0.05）。（3）肿瘤标志物测定水平与病理类型有关,血清NSE水平升高以小细胞肺癌为主,CYFRA211以鳞癌为主,而CAl25则以腺癌为主。（4）不同组合的联合检测较单项检测均能提高敏感度和准确度,但特异度略有降低。在联合检测效能的评价中,7种肿瘤标志物组合为最佳检测指标。结论肿瘤标志物联合检测可提高肺癌诊断的敏感性和准确性。

Diagnostic Value of Multiple Serum Tumor Markers in Lung Cancer

Objective To evaluate the clinical value of single and combination detection of seven serum tumor markers in the diagnosis of lung cancer.Methods Serum levels of CEA,CA125,CYFRA211,NSE,TSGF,SCC and TPS collected from 234 cases of lung cancer,84 cases of benign lung diseases and 28 healthy volunteers were detected.Results（1） The levels of the seven kinds of tumor markers in the lung cancer group were significantly higher than those in the benign pulmonary lesion group（all P0.05） and healthy volunteer group（all P0.01）.（2） The positive rates of seven kinds of tumor markers in the lung cancer group were significantly higher than those in the benign pulmonary lesion group（all P0.05）.（3） The level of tumor markers had close correlation with the pathology type.The higher levels of NSE,CYFRA211,CA125 appeared in small cell lung cancer,squamous cell carcinoma and adenocarcinoma respectively.（4） The sensitivity and accuracy of different kinds of combinations in diagnosis of lung cancer was remarkably higher than that of the single detection,even though the specificity could be slightly lower down.The combination of seven tumor markers was the best detection in the efficacy evaluation of combination detections.Conclusion The combination detections further improved the diagnostic sensitivity and accuracy in lung cancer.