Division of Nuclear Medicine, Yonsei University College of Medicine, Seoul, South Korea.
Am J Clin Pathol. 2013 Mar;139(3):309-16. doi: 10.1309/AJCPYOJYG56UNBSZ.
This study evaluated the diagnostic usefulness of tumor marker concentrations in cytologic fluids (CF) for subtyping non-small cell lung cancer (NSCLC) and assessed the relationship between fluorine-18-fluorodeoxyglucose ((18)F-FDG) uptake with serum and CF tumor marker levels. This prospective study included 88 patients diagnosed with adenocarcinoma or squamous cell carcinoma (SCC). Cytokeratin-19 fragment (CYFRA 21-1), carcinoembryonic antigen (CEA), and squamous cell carcinoma antigen (SCCA) concentrations in the CF samples were correlated with serum tumor marker concentrations, (18)F-FDG uptake, and NSCLC subtype. Fifty-eight patients were diagnosed with adenocarcinoma. Multivariate analysis revealed higher CF and serum SCCA levels; smoking status predicted SCC from adenocarcinoma. CF SCCA showed the highest accuracy (83%) in distinguishing between SCC and adenocarcinoma. CF samples obtained during routine needle aspiration biopsy procedure contain tumor marker levels sufficient to distinguish between SCC and adenocarcinoma; CF SCCA had the highest diagnostic accuracy.
本研究评估了细胞液（CF）中肿瘤标志物浓度对非小细胞肺癌（NSCLC）亚型的诊断价值，并评估了氟-18-氟代脱氧葡萄糖（（18）F-FDG）摄取与血清和 CF 肿瘤标志物水平之间的关系。这项前瞻性研究纳入了 88 名诊断为腺癌或鳞状细胞癌（SCC）的患者。CF 样本中的细胞角蛋白 19 片段（CYFRA 21-1）、癌胚抗原（CEA）和鳞状细胞癌抗原（SCCA）浓度与血清肿瘤标志物浓度、（18）F-FDG 摄取和 NSCLC 亚型相关。58 例患者被诊断为腺癌。多变量分析显示 CF 和血清 SCCA 水平较高；吸烟状况预测 SCC 与腺癌。CF SCCA 对 SCC 和腺癌的鉴别准确率最高（83%）。在常规针吸活检过程中获得的 CF 样本中含有足以区分 SCC 和腺癌的肿瘤标志物水平；CF SCCA 具有最高的诊断准确性。
