不同标本肿瘤标志物联合检测对肺癌的诊断价值刘大鹰1，胡灼君1，农天雷2，林敏2DiagnosticvalueofcombinedtumormarkersassaysindifferentsamplespatientswithlungcancerLIUDaying1，HUZhuojun1，NONGTianlei2，LINMin21DepartmentofRespiration;2DepartmentofNuclearMedicine，LiutieCentralHospitalofLiuzhouCity，GuangxiLiuzhou545007，China．【Abstract】Objective:Toevaluatetheclinicalsignificanceofassayingcarcino－embryonicantigen(CEA)，car-bohydrateantigens(CAl25andCAl9－9)andCytokeratin19fragment(CYFRA21－1)inserum，sputum，broncho－alveolarlavagefluid(BALF)andpleuraleffusionofpatientswithlungcancer．Methods:Usingthemethodofche-mi－luminescentenzymeimmunoassaywithacommerciallyavailableenzymeimmunoassaykit，52caseswithlungcancerand46caseswithbenignlungdiseasesunderwentassayofCEA，CA125，CA199andCYFRA21－1inserum，sputum，BALFandpleuraleffusion．Results:Ofthe52caseswithlungcancer，thepositivepercentagesofcombinationassaysofCEA，CA125，CA199andCYFRA21－1wereasfollows:69．2%inserum，90．4%insputum，88．5%inBALFand82．1%inpleuraleffusion，respectively;Butthepositivepercentagesofthosewithbenignlungdiseaseswere19．6%，26．1%、23．9%，21．7%，respectively．Thepositivepercentagesofcombinationofthesetumormarkersassaysinpatientswithlungcancerwassignificantlyhigherthaninthosewithnonmalignantrespiratorydiseases(P＜0．05)．Amongthe52patientswithlungcancer，thediagnosticsensitivityofcombinationofthesetumormarkersassaysinsputumorBALFwassignificantlyhigherthanthoseinserum(P=0．01;P=0．02)．Comparedwiththesingleser-umsamplesthatthesetumormarkersweremeasured，thecombinationof2or3ofthesesamplescouldimprovethesensitivityandaccuratevalueinthediagnosisoflungcancer(P＜0．05)．Conclusion:ToassayCEA，CA125，CA199andCYFRA21－1inserum，sputum，BALFandpleuraleffusionwasavaluableaidindiagnosisoflungcancer，andcomparedwiththesingleserumsamplethatthesetumormarkersweremeasured，thecombinationof2or3ofthesesamplescouldimprovesensitivityandaccuratevalueinthediagnosisoflungcancer．【Keywords】lungneoplasm;tumormarkers;serum;sputum;bronchoalveolarlavagefluid;pleuraleffusion;diagnosisModernOncology2012，20(09):1838－1841【摘要】目的:检测血液、痰液、支气管肺泡灌洗液(BALF)、胸腔积液四种标本中癌胚抗原(CEA)、癌抗原125(CA125)、癌抗原199(CA199)和细胞角蛋白21－1片段(CYFRA21－1)的浓度，探讨不同标本肿瘤标志物(TM)联合检测在肺癌诊断中的意义。方法:采用化学发光免疫分析法检测52例肺癌和46例肺部良性病变患者血液、痰液、BALF、胸腔积液中CEA、CA125、CA199和CYFRA21－1的浓度。结果:52例肺癌患者血液、痰液、BALF、胸腔积液中四种TM联合检测的阳性率分别为69．2%、90．4%、88．5%和82．1%;而46例肺部良性病变患者的阳性率分别为19．6%、26．1%、23．9%、21．7%。经统计学检验两组间四种标本TM联合检测阳性率差异有统计学意义(P＜0．05)。肺癌组不同标本之间TM联合检测的阳性率差异有统计学意义(P=0．02);痰液和BALF标本TM联合检测较血液临床意义更大(P=0．01;P=0．02)。联合两个或三个标本检测与单个血液标本检测相比，其差异有统计学意义(P＜0．05)。结论:不同标本肿瘤标志物CEA、CA125、CA199和CYFRA21－1联合检测对肺癌的诊断具有一定的意义。联合不同标本检测四种TM能提高肺癌诊断的敏感性。【关键词】肺肿瘤;肿瘤标记;生物学;痰;支气管肺泡灌洗液;胸腔积液;诊断【中图分类号】R734．2【文献标识码】ADOI:10．3969/j．issn．1672－4992．2012．09．24【文章编号】1672－4992－(2012)09－1838－04【收稿日期】2012－02－14【修回日期】2012－02－29【基金项目】广西壮族自治区柳州市科技局基金(编号:2009021525)【作者单位】柳州市...
