Chen Feng, Li Wei-min, Wang Dong-mei, Gao Shu-sheng, Bao Yong, Chen Wen-bin, Liu Dan
Department of Respiratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2008 Sep;39(5):832-5.
To investigate the clinical significance of a combination of several serum tumor markers in the diagnosis of lung cancer.
Serum CEA, CA125, CA199, CYFRA21-1 and NSE were measured with RIA, chromatometrychemoluminescence, ELISA and biochemoluminescence methods respectively in 340 patients with lung cancers at different TNM stages, 120 patients with benign lung diseases, and 45 healthy people. The sensitivities, specificities and accuracies of different combination of those markers for the diagnosis of lung cancers were compared.
CYFRA21-1 had the highest sensitivity and accuracy (60.0% and 70.3%) and CA199 had the highest specificity (99.4%) for detecting lung cancers. CYFRA21-1 had the highest sensitivity (79.6%) for detecting squamous carcinoma. CEA had the highest sensitivity of (75.7%) for detecting adenocarcinoma. NSE had the highest sensitivity (76.2%) for detecting small cell lung cancers (SCLC). The combination of several serum tumor markers had higher sensitivities than the single marker for the diagnosis of lung cancers. With two markers, the combination of CYFRA21-1 and NSE had the highest sensitivity and accuracy (82.9% and 83.4%), while the combination of CA125 and CA199 had the highest specificity (94.5%). With three markers, the combination of CEA, NSE and CYFRA21-1 had the highest sensitivity and accuracy (89.1% and 85.1%), while the combination of CEA, CA125 and CA199 had the highest specificity (86.7%). The combination of CEA, CA125, CA199, CYFRA21-1 and NSE produced the best value, with a sensitivity of 93.8%, a specificity of 71.5%, and an accuracy of 86.5%.
Serum CEA, CA125, CA199, CYFRA21-1 and NSE are helpful markers for the diagnosis of lung cancer. The combination of the markers can improve the sensitivity and accuracy of the diagnosis.
探讨多种血清肿瘤标志物联合检测在肺癌诊断中的临床意义。
分别采用放射免疫分析（RIA）、色谱法、化学发光法、酶联免疫吸附测定（ELISA）和生物发光法检测340例不同TNM分期的肺癌患者、120例肺部良性疾病患者及45例健康人的血清癌胚抗原（CEA）、糖类抗原125（CA125）、糖类抗原199（CA199）、细胞角蛋白19片段（CYFRA21-1）和神经元特异性烯醇化酶（NSE）。比较不同标志物组合对肺癌诊断的敏感性、特异性和准确性。
CYFRA21-1检测肺癌的敏感性和准确性最高（分别为60.0%和70.3%），CA199检测肺癌的特异性最高（99.4%）。CYFRA21-1检测肺鳞癌的敏感性最高（79.6%）。CEA检测肺腺癌的敏感性最高（75.7%）。NSE检测小细胞肺癌（SCLC）的敏感性最高（76.2%）。多种血清肿瘤标志物联合检测对肺癌诊断的敏感性高于单一标志物。两种标志物联合时，CYFRA21-1与NSE联合的敏感性和准确性最高（分别为82.9%和83.4%），而CA125与CA199联合的特异性最高（94.5%）。三种标志物联合时，CEA、NSE与CYFRA21-1联合的敏感性和准确性最高（分别为89.1%和85.1%），而CEA、CA125与CA199联合的特异性最高（86.7%）。CEA、CA125、CA199、CYFRA21-1与NSE联合检测的效果最佳，敏感性为93.8%，特异性为71.5%，准确性为86.5%。
血清CEA、CA125、CA199、CYFRA21-1和NSE是肺癌诊断的有用标志物。联合检测这些标志物可提高诊断的敏感性和准确性。
