Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.
Arch Pathol Lab Med. 2011 Dec;135(12):1570-5. doi: 10.5858/arpa.2010-0717-OA.
Some tumor markers, including carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (CYFRA 21-1), are used for the detection of lung cancer; however, their use is limited because of low sensitivities and high false-positive rates.
To investigate the usefulness of an anti-p53 assay in detecting lung cancer and to compare the anti-p53 to CEA and CYFRA 21-1 tumor markers.
Serum samples were collected from 82 patients with lung cancer. Sera were also collected from 79 patients with or without benign pulmonary disease for the control group. All 161 specimens were assayed for CEA, CYFRA 21-1, and anti-p53. The diagnostic performances of these markers were compared using receiver operating characteristic analysis.
The receiver operating characteristic area under the curve values of CYFRA 21-1, CEA, and anti-p53 for discriminating lung cancers from benign or healthy conditions were 0.79, 0.81, and 0.79, respectively. Area under the curve for the 3 markers in combination was 0.90. The sensitivities of those markers for lung cancer detection were respectively 39.0%, 53.7%, and 34.1% at 94.9% specificity, and the cutoff levels at those sensitivities and specificities were 4.5 ng/mL for CYFRA 21-1, 5.4 ng/mL for CEA, and 2.7 U/mL for anti-p53. We found 79.3% positive results for patients with lung cancer by any of the 3 markers, and 12.2% were positive only for anti-p53. All patients without cancer had negative results for 2 or all 3 markers.
Anti-p53 combined with other conventional markers is helpful in increasing the sensitivity and specificity for detecting lung cancer.
一些肿瘤标志物，包括癌胚抗原（CEA）和细胞角蛋白 19 片段（CYFRA 21-1），被用于肺癌的检测；然而，由于其敏感性低和假阳性率高，其应用受到限制。
研究抗-p53 检测在肺癌检测中的应用，并将抗-p53 与 CEA 和 CYFRA 21-1 肿瘤标志物进行比较。
收集 82 例肺癌患者的血清样本。还为对照组的 79 例有或无良性肺部疾病的患者收集了血清。对所有 161 例标本进行 CEA、CYFRA 21-1 和抗-p53 检测。使用接收者操作特征分析比较这些标志物的诊断性能。
CYFRA 21-1、CEA 和抗-p53 区分肺癌与良性或健康状况的受试者工作特征曲线下面积分别为 0.79、0.81 和 0.79。3 种标志物联合的曲线下面积为 0.90。这些标志物用于肺癌检测的敏感性分别为 39.0%、53.7%和 34.1%，特异性为 94.9%，在这些敏感性和特异性下的截止值分别为 4.5ng/mL 的 CYFRA 21-1、5.4ng/mL 的 CEA 和 2.7U/mL 的抗-p53。我们发现 3 种标志物中有 79.3%的肺癌患者结果阳性，12.2%的患者仅抗-p53 阳性。所有无癌症的患者 2 种或 3 种标志物的结果均为阴性。
抗-p53 与其他常规标志物联合有助于提高肺癌检测的敏感性和特异性。
