如何在支气管肺泡灌洗中检测肿瘤标志物。

How to express tumor markers in bronchoalveolar lavage.

作者信息

Gómez de Terreros Caro F J, Alvarez-Sala R, Prados M C, Callol L, Gómez de Terreros Sánchez F J, Villamor J

机构信息

Pneumology Service, La Paz Hospital, Autónoma University, Madrid, Spain.

出版信息

Int J Biol Markers. 2004 Jan-Mar;19(1):67-71.

PMID:15077929

Abstract

INTRODUCTION

Bronchoalveolar lavage (BAL) is a fundamental technique in the diagnosis of different respiratory diseases including lung cancer. Tumor marker values can be determined in the BAL fluid, but controversy still exists about how to express the results.

OBJECTIVE

The aim of this study was to determine the best method of expressing tumor markers in BAL, either referring to total proteins or volume of fluid recovered.

PATIENTS AND METHODS

A prospective, randomized, non-blind study was carried out. Seventy-six patients (72 men and 4 women) diagnosed with lung cancer and 17 subjects without respiratory disease were included. BAL was performed in all patients and the fluid retrieved was divided into two fractions: a bronchiolar fraction (F0) and an alveolar fraction (F1). Five tumor markers: cytokeratin fragment 19 (CYFRA 21-1), squamous cell carcinoma antigen (SCC), tissue polypeptide antigen (TPA), tissue polypeptide-specific antigen (TPS) and neuron-specific enolase (NSE) as well as total protein were measured in both fractions. The concentrations were expressed in relation to the volume of BAL fluid recovered (ng or mU/mL) and in milligrams of total protein of lavage fluid (ng or mU/mg TP). The SPSS 11.01 software was used for statistical analysis. Mann-Whitney U test and ROC curves were developed when significant differences were found.

RESULTS

We found significant differences in the CYFRA 21-1 values in the two BAL fractions and in both ways of expressing its concentration; in SCC in F1 expressed in ng/mg TP; in TPA in F0 expressed in mU/mg TP; in TPS in both fractions expressed in mU/mg TP, and in NSE in both fractions in ng/mg TP. The markers that best differentiated tumors from controls (ROC curves) were CYFRA 21-1 in F0 and NSE in both fractions in ng/mg TP.

CONCLUSIONS

Our study demonstrates that the concentrations of tumor markers in BAL expressed in relation to total protein were more effective than if expressed in mL of BAL fluid collected.

摘要

引言

支气管肺泡灌洗（BAL）是诊断包括肺癌在内的不同呼吸系统疾病的一项基本技术。可在BAL液中测定肿瘤标志物值，但关于如何表达结果仍存在争议。

目的

本研究的目的是确定在BAL中表达肿瘤标志物的最佳方法，是参照总蛋白还是回收的液体体积。

患者和方法

进行了一项前瞻性、随机、非盲研究。纳入了76例诊断为肺癌的患者（72例男性和4例女性）以及17例无呼吸系统疾病的受试者。对所有患者进行BAL，并将回收的液体分为两部分：细支气管部分（F0）和肺泡部分（F1）。在两部分中测量了五种肿瘤标志物：细胞角蛋白片段19（CYFRA 21-1）、鳞状细胞癌抗原（SCC）、组织多肽抗原（TPA）、组织多肽特异性抗原（TPS）和神经元特异性烯醇化酶（NSE）以及总蛋白。浓度以回收的BAL液体积（ng或mU/mL）和灌洗液总蛋白毫克数（ng或mU/mg TP）表示。使用SPSS 11.01软件进行统计分析。当发现显著差异时，绘制曼-惠特尼U检验和ROC曲线。

结果

我们发现两种BAL部分中CYFRA 21-1值以及两种表达其浓度的方式均存在显著差异；F1中SCC以ng/mg TP表示存在显著差异；F0中TPA以mU/mg TP表示存在显著差异；两部分中TPS以mU/mg TP表示存在显著差异，两部分中NSE以ng/mg TP表示存在显著差异。能最好地区分肿瘤与对照的标志物（ROC曲线）是F0中的CYFRA 21-1以及两部分中以ng/mg TP表示的NSE。