Haro M, Vizcaya M, Jiménez J, Quintanilla M L, Núñez A, Tornero A
Sección de Neumología, Hospital General, Albacete.
An Med Interna. 2000 Apr;17(4):186-91.
We have examined the carcinoembryonic antigen (CEA) and other tumor markers (immunoglobulins, CA 19.9, LDH, alpha-fetoprotein and alpha-1-antitrypsin) with the purpose of recognize their utility in patients with hemoptysis and patients older than 45 years with a positive smoking history and hemoptysis.
We measured, analyzed and compared these markers in 336 patients with a known etiology of hemoptysis divided in group I (malignant etiology) with 101 cases (30.1%) and II (nonmalignant) with 235 cases (69.9%) (p < 0.001).
The values of CEA, LDH and CA 19.9 were increased in group I, without differences when we compared immunoglobulins (G, A and M), alpha-fetoprotein and alpha-1-antitrypsin in both groups. CEA and LDH were increased significantly according to the disease extent in nonsmall cell lung carcinoma. Smokers had an increased CEA only in group II. Plasma values of CEA higher than 5 ng/mL meant that the likelihood of bronchial carcinoma was high. Our markers proved to be more specific and with a high positive or negative predictive values than sensitives. These results would suggest that they are not of great help for early diagnosis of lung cancer, however an increase of CEA, LDH and CA 19.9 plasma concentrations could suggest with high probability a bronchial carcinoma, improving their diagnostic sensibility when we used them in combination.
我们检测了癌胚抗原（CEA）及其他肿瘤标志物（免疫球蛋白、CA 19.9、乳酸脱氢酶、甲胎蛋白及α1抗胰蛋白酶），目的是明确它们在咯血患者以及年龄大于45岁且有咯血史的吸烟患者中的应用价值。
我们对336例已知咯血病因的患者进行了这些标志物的检测、分析和比较，这些患者被分为I组（恶性病因）101例（30.1%）和II组（非恶性病因）235例（69.9%）（p<0.001）。
I组中CEA、乳酸脱氢酶和CA 19.9的值升高，而两组间免疫球蛋白（G、A和M）、甲胎蛋白及α1抗胰蛋白酶的比较无差异。在非小细胞肺癌中，CEA和乳酸脱氢酶根据疾病程度显著升高。吸烟者仅在II组中CEA升高。血浆CEA值高于5 ng/mL意味着患支气管癌的可能性很大。我们的标志物被证明比敏感性更具特异性，且具有较高的阳性或阴性预测价值。这些结果表明它们对肺癌的早期诊断帮助不大，然而，CEA、乳酸脱氢酶和CA 19.9血浆浓度的升高很可能提示支气管癌，联合使用时可提高其诊断敏感性。
