摘要
目的探讨血清肿瘤标志物癌胚抗原(CEA)、糖类抗原125(CA125)、细胞角蛋白19片段(Cyfra21-1)联合检测对晚期非小细胞肺癌患者的临床意义。方法收集滨州医学院烟台附属医院2013年1月—2015年11月治疗的肺癌患者,以病理明确、可以定期监测血清肿瘤标志物(血清CEA、CA125、Cyfra21-1)的晚期患者作为研究对象,回顾性分析三种血清肿瘤标志物表达程度,并分析其与肺癌组织学类型、进展时间相关性。结果符合研究入组标准的患者共90例(肺鳞癌43例,肺腺癌47例)。CEA、CA125及Cyfra21-1在肺鳞癌中阳性表达率分别为46.51%、53.49%和60.47%;肺腺癌分别为44.68%、59.97%和2.13%;Cyfra21-1在腺癌中表达率低,提示可以不作为腺癌检测的指标;CEA和CA125联合检测的阳性表达率在鳞癌和腺癌中分别为86.05%、68.09%,联合检测阳性表达率均明显高于单一指标,P值分别为0.004、0.002,提示联合检测肿瘤标志物可提高诊断的敏感性。24例(64.86%)肺鳞癌患者出现血清学肿瘤标志物增高早于影像学改变,提前的中位时间为肺鳞癌1.6个月;而肺腺癌为20例(62.50%),早于影像学改变的中位时间为2.3个月。结论联合检测尤其是CEA、CA125可提高诊断的敏感性,弥补阳性表达率较低的不足;Cyfra21-1在腺癌中表达率低,可以不作为腺癌检测的指标;血清学肿瘤标志物增高对疾病进展有一定预测作用,提前2个月左右。
Objective To investigate the clinical value of combined detection of carcinoembryonic antigen（CEA）,carbohydrate antigen 125（CA125）,cytokeratin 19 fragment（Cyfra21-1）in patients with Advanced non-small cell lung cancer.Methods StageⅣ non-small cell lung cancer patients during January2013 and November 2015 treated in author＇s hospital were collected,who were confirmed by clinical pathology and can be regular monitored of serum tumor markers（serum CEA,CA125,Cyfra21-1）.And we analyzed the serum level of CEA,CA125,Cyfra21-1in these patients and the relationship between the serum level of the three biomarker with histological types and the time to progression.Results According to our inclusion criteria,there were total 90 cases（43 cases of lung squamous cell carcinoma,47 cases of lung adenocarcinoma）in this study.The positive rates of CEA,CA125 and Cyfra21-1 were 46.51%,53.49%,60.47%in squamous cell carcinoma and were 44.68%,59.97% and 2.13%in adenocarcinoma,respectively;Cyfra21-1 showed a low expression in adenocarcinoma,suggesting that Cyfra21-1 can not be an biomarker in adenocarcinoma;the positive rate of CEA and CA125 combinated detection was 86.05%in squamous cell carcinoma and 68.09% in adenocarcinoma.The positive rate of combinated detection was significantly higher than the rate of a single detection（P=0.004,0.002）,indicating combined detection of tumor markers may improve diagnostic sensitivity.In the patients with squamous cell lung carcinoma,24（64.86%）patients showed that serum tumor markers increased earlier than radiographic changes and the median time in advance for that was 1.6 months;in adenocarcinoma patients there were 20 cases（62.50%）showed that serum tumor markers increased earlier than radiographic changes and the median time in advance was 2.3 months.Conclusions The combined detection especially the combination of CEA and CA125 can improve the sensitivity of diagnosis,which can compensate the low positive rate during the diagnosis.The Cyfra21-1 expression in ad
出处
《中国煤炭工业医学杂志》
2016年第6期826-830,共5页
Chinese Journal of Coal Industry Medicine
基金
中国老年学学会(编号:CGOS-02-2014-1-1-00300)
