肿瘤标志物联合检测在肺癌诊断中的价值李海燕打刘红S王静¥苗丽君°摘要：目的研究肺癌患者血清中，肿瘤标志物肿瘤相关抗原125(CA125)、肿瘤相关抗原153(CA153).肿瘤相关抗原199(CA199)、癌胚抗原(CEA)、神经特异性烯醇化酶(NSE)、非小细胞肺癌抗原21-1(CYFRA21-1)浓度在肺癌诊断中的价值。方法选取郑州大学第一附属医院2010年6月至2011年6月体检及入院患者232例血清标本，采用电化学荧光分析法(ECLIA)分析患者血清中6种肿瘤标志物的浓度，并从中选取最佳的组合进行筛检，评价其在肺癌诊断中的价值。结果对肺癌患者进行单项肿瘤标志物检测，鳞癌组，CA125灵敏度最高，为40.91%；腺癌组CEA、CYFRA21J灵敏度高，分别为49.06%>449%；小细胞肺癌组CEA、CYFRA21J、NSE灵敏度高，分别为39.13%、26.09%、30.43%；单项检测CEA诊断价值最高，约登指数为0.3572；联合检测CA125+CYFRA21-1+CEA可以明显提高筛检的灵敏度可达65.14%,特别对于肺腺癌患者，可达90%以上；联合检测CYFRA21-1+CEA,特异度及约登指数分别为84.91%>0.4271,诊断价值最高。结论单项检测CEA在诊断肺癌方面价值最高，尤其对于肺腺癌有更高的提示价值；联合检测CA125+CYFRA21-1+CEA对于肺癌诊断灵敏度较高，可以作为高危人群或体检筛查的指标；对于影像学支持肺癌但组织细胞学不易确诊的患者，检测患者血清CYFRA21・1+CEA,对于肺癌诊断会有很大的帮助。关键词：肺癌、肿瘤标志物、癌胚抗原、神经特异性烯醇化酶、肿瘤相关抗原125、肿瘤相关抗原153、肿瘤相关抗原199、、非小细胞肺癌抗原21-1：R734.2文献标识码：Amarkersuniteddetectioninthediagnosticvalueoflungcancer7•3•••zlLiHaiyan,LittHong,Wang激ng,MiaoLi激m.^DepartmentofRespiratory^,theFirstAffiliatedHospital,ZhengzhouUniversity;theopenKeyClinicalMedicalExperimentalLaboratory^ofHenanProvince,Zhengzhou450052Abstract:ObjectiveToresearchCA125,CA153，CA199,CEA，NSEandCYFRA21-l,inthebloodserumthepatientswhohavelungcancer,theconcentrationofthoseindexeswhetherhavevalueinthediagnosisdiagnosticoflungcancer.MethodsSelectinthefirstaffiliatedhospitalofZhengzhouUniversity,fromJune,2010,to2011inJunetoaccept232outpatientsandinpatientsserumspecimens,bytheelectrochemicalfluorescenceanalysis(ECLIA)analysisinpatientswiththeserumconcentrationofthe6tumormarkers,andchoosethebestcombinationforscreening,evaluationinthediagnosticvalueofthelungcance匸ResultsDetectinthepatientswithlungcancerinindividualtumormarkers,asinthesquamouscellgroup,thesensitivityofCAI25isthehighest,is40.91%;asintheAdenocarcinomagroup,thesensitivityofCYFRA21-1andCEAishigh,for49.06%,48.49%respectively;asintheSmallcelllungcancergroup,thesensitivityofCEA,CYFRA21-1,NSEishigh,of39.13%,26.09%and30.43%respectively;thespecificityofCA153,CA199isthehighest,both98.11%,andCAI25isminimum,is83.00%;Forpatientswithlungcancer,tumormarkersuniteddetection,CA125+CYFRA21-1+CEA,thesensitivityofthepositivecanbeincreasedby65.14%.Especiallyforpatientswithlungadenocarcinoma,canincreaseto90%above.ThedegreeofaccurancyofCYFRA21-1andCEAismaximum,for84.91%,0.4271respectively.ConclusionSingledetection,theCEAinlungcancerdiagnosisaccuracyisthebest,andhasveryhighvalueforthelungadenocarcinoma.Uniteddetection,thesensitivityofCYFRA21+CA125+CEAforlungcancerdiagnosisishighest,andcanbeusedasahigh-riskphysicalexaminationtestscreeningindex.Forpatientswhoseimagingsupportlungcancerbuttheirorganizationcytologycannoteasilybediagnosed,detecttheirsemmforCYFRA21-1+CEAforlungcancerdiagnosis,therewillbealotofhelp.Keywords：Lungcancer;tumormarkers;CEA;NSE;CA125;CA153;CA199;CYFRA21-1ChineseLibraryClassfication:R734.2Documentcode:ALungcancer近年來，肺癌发病率呈逐年上升趋势，现居于...