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目的探讨联合检测细胞角蛋白19降解片段-2G2(CK19-2G2)、神经元特异性烯醇化酶(NSE)及癌胚抗原(CEA)的含量在肺癌诊断中的应用价值。方法采用CLIA对120例肺癌患者血清中CK19-2G2、NSE和CEA进行含量测定,用SPSS 10.0统计学软件进行数据分析。结果 (1)肺癌患者组血清CK19-2G2、NSE、CEA浓度高于良性肺病组,差异有统计学意义(P<0.01)。三种肿瘤标记物中,鳞癌CK19-2G2浓度高于小细胞肺癌组和肺腺癌组(P<0.01)。小细胞肺癌NSE浓度高于肺磷癌组和肺腺癌组(P<0.01)。肺腺癌血CEA浓度高于肺磷癌组和小细胞肺癌组(P<0.01)。(2)肿瘤标志物CK19-2G2对肺鳞癌的敏感度高于肺腺癌和小细胞肺癌(P<0.01);NSE对小细胞肺癌的敏感度高于肺鳞癌和肺腺癌(P<0.01);CEA对肺腺癌、肺鳞癌、小细胞肺癌的敏感度差异无统计学意义(P>0.05)。(3)联合检测肿瘤标志物对肺癌诊断的特异性变化不大,但敏感度由单项检测的51.7%、47.5%、46.7%提高到90.8%(P<0.01);准确度由单项检测的61.3%、59.4%、59.4%提高到92.5%(P<0.01)。结论联合检测CK19-2G2、NSE及CEA血清肿瘤标志物,在特异性降低不是很明显的情况下,可以大大提高肺癌诊断的敏感度。同时还可以根据CK19-2G2、NSE、CEA的浓度和各自对不同病理类型肺癌的敏感度,提示肺癌病理分型。
Objective To investigate the value of combined detection of CK19-2G2, NSE and CEA in the diagnosis of lung cancer. Methods Serum levels of CK19-2G2, NSE and CEA in 120 patients with lung cancer were determined by CLIA and analyzed by SPSS 10.0 statistical software. Results (1) The serum levels of CK19-2G2, NSE and CEA in patients with lung cancer were significantly higher than those in patients with benign lung disease (P <0.01). Among the three tumor markers, the concentration of CK19-2G2 in squamous cell carcinoma was higher than that in small cell lung cancer and lung adenocarcinoma (P <0.01). The NSE concentration in small cell lung cancer was higher than that in lung cancer group and lung adenocarcinoma group (P <0.01). The serum CEA concentration in lung adenocarcinoma was higher than that in lung PHC group and small cell lung cancer group (P <0.01). (2) The sensitivity of tumor marker CK19-2G2 to lung squamous cell carcinoma was higher than that of lung adenocarcinoma and small cell lung cancer (P <0.01). The sensitivity of NSE to small cell lung cancer was higher than that of lung squamous cell carcinoma and lung adenocarcinoma <0.01). There was no significant difference in the sensitivity of CEA to lung adenocarcinoma, lung squamous cell carcinoma and small cell lung cancer (P> 0.05). (3) The combined detection of tumor markers has little effect on the diagnosis of lung cancer, but the sensitivity is increased from 51.7%, 47.5%, 46.7% to 90.8% (P <0.01); the accuracy is from 61.3 %, 59.4%, 59.4% to 92.5% (P <0.01). Conclusions The combined detection of serum tumor markers of CK19-2G2, NSE and CEA can greatly improve the sensitivity of lung cancer diagnosis if the specific reduction is not obvious. At the same time, according to CK19-2G2, NSE, CEA concentrations and their sensitivity to different pathological types of lung cancer, prompted pathological lung cancer.