Devine P, Yarker J, Fong K, McGuckin M, Scells B, Ward B, Thynne G, Zimmerman P
PRINCE CHARLES HOSP,DEPT THORAC MED,BRISBANE,QLD,AUSTRALIA.
Int J Oncol. 1994 May;4(5):1129-35. doi: 10.3892/ijo.4.5.1129.
Serum CASA, CEA, CYFRA 21-1, NSE, MSA, TPA, and TPS were determined in patients with lung cancer (LC), benign lung disease (BL), and healthy control (HC) donors. Using predefined cutpoints, the cytokeratin-related markers TPA, TPS, and CYFRA showed the highest sensitivity in non-small cell lung cancer (TPA 69%, TPS 63%, CYFRA 54%), while NSE gave the highest sensitivity in small cell lung cancer (50%), indicating that these markers may be most appropriate in monitoring the course of disease and the patients response to therapy. Receiver-operator analysis was performed to compare assays at the same specificity. At high specificities (greater than or equal to 95%), CYFRA was significantly better than all assays except CASA in the LC vs. HC and LC vs. non-infectious BL comparisons (p<0.05), while CEA was the only assay which was not significantly different to CYFRA in the LC vs. BL comparison. CASA was of particular value when used in combination with these markers, as the sensitivity was increased. In addition, pretreatment CASA was the best indicator of patient survival (one year survival of 83% for patients with CASA <5 units/ml and 10% for patients with CASA greater than or equal to 5 units/ml).
在肺癌(LC)患者、良性肺部疾病(BL)患者和健康对照(HC)供体中测定血清癌胚抗原(CASA)、癌胚抗原(CEA)、细胞角蛋白片段21-1(CYFRA 21-1)、神经元特异性烯醇化酶(NSE)、巨唾液酸糖蛋白(MSA)、组织多肽抗原(TPA)和组织多肽特异性抗原(TPS)。使用预先定义的切点,细胞角蛋白相关标志物TPA、TPS和CYFRA在非小细胞肺癌中显示出最高的敏感性(TPA为69%,TPS为63%,CYFRA为54%),而NSE在小细胞肺癌中敏感性最高(50%),这表明这些标志物可能最适合用于监测疾病进程和患者对治疗的反应。进行了受试者工作特征分析以在相同特异性下比较检测方法。在高特异性(大于或等于95%)时,在LC与HC以及LC与非感染性BL的比较中,CYFRA除CASA外显著优于所有检测方法(p<0.05),而在LC与BL的比较中,CEA是唯一与CYFRA无显著差异的检测方法。当与这些标志物联合使用时,CASA具有特殊价值,因为敏感性会增加。此外,治疗前的CASA是患者生存的最佳指标(CASA<5单位/毫升的患者一年生存率为83%,CASA大于或等于5单位/毫升的患者一年生存率为10%)。