血清肿瘤标记物对非小细胞肺癌的诊断价值

摘要

Objective: To investigate the diagnostic value of single and combined determination of serum tissue polypeptide specific antigen( TPS ), cytokeratin 19 fragment(Cyfra21-1 ) and ferritin in patients with non-small cell lung cancer( NSCLC ). Method: The levels of serum TPS were detected in 108 patients with NSCLC and 86 cases of healthy adults by enzyme-linked immunosorbent assay( ELASA ),and the levels of Cyfra21-1 and ferritin were detected by electrochemiluminescence. Result: The serum levels and positive rates of the three tumor markers in lung cancer group were significantly higher than those in healthy adults( P <0. 01 ). TPS showed higher sensitivity than the other two tumor markers in the diagnosis of pulmonary ade-nocarcinoma( P<0. 05 );The serum levels and positive rates of Cyfra21-1 in squamous carcinoma group were significantly higher than those in adenocarcinoma group( P<0. 01 ). TPS showed the highest sensitivity and Cyfra21-1 showed the highest sensitivity in single tumor marker detection; Their combined detection could reduce the specificity to a certain extent,but could significantly improve the sensitivity and the accuracy( P< 0. 01 ). Conclusion: The single and combined detection TPS,cyfra21-l and ferritin has high clinical value in the diagnosis of NSCLC and the differentiation of pathology types.%目的 探讨血清组织多肽特异性抗原( TPS)、细胞角蛋白19片段(Cyfra21-1)和铁蛋白(Ferritin)单项及联合检测对非小细胞肺癌的诊断价值.方法 采用酶联免疫吸附(ELISA)法测定108例NSCLC患者和86例健康人的血清中TPS水平,同时用电化学发光法测定Cyfra21-1和Ferritin水平.结果 肺癌组三项血清肿瘤标记物水平及阳性率均显著高于健康对照组(P<0.01).TPS诊断肺腺癌的敏感性优于其他两项肿瘤标记物(P<0.05);Cyfra21-1在鳞癌组血清浓度及阳性率明显高于腺癌组(P<0.01).三项肿瘤标记物单项检测时,TPS的敏感性最高,Cyfra21-1的特异性最高;三项联合检测时的特异性有所降低,但敏感性和准确率显著提高(P<0.01).结论 TPS、Cyfra21-1和Ferritin单项及联合检测对NSCLC的诊断及病理学类型的鉴别有较高的临床价值.