Wang Bing, He Yu-Jie, Tian Ying-Xing, Yang Rui-Ning, Zhu Yue-Rong, Qiu Hong
Department of Clinical Lab, the 81th Hospital of PLA, Nanjing, China E-mail :
Asian Pac J Cancer Prev. 2014;15(22):9611-4. doi: 10.7314/apjcp.2014.15.22.9611.
To investigate the clinical value in lung cancer of a combination of four serum tumor markers, haptoglobin (Hp), carcinoembryonic antigen (CEA), neuron specific enolase (NSE) as well as the cytokeratin 19 fragment (CYFRA21-1).
Serum Hp (with immune-turbidimetric method), CEA, NSE, CYFRA21-1 (with chemiluminescence method) level were assessed in 193 patients with lung cancer, 87 patients with benign lung disease and 150 healthy controls. Differences of expression were compared among groups, and joint effects of these tumor markers for the diagnosis of lung cancer were analyzed.
Serum tumor marker levels in patients with lung cancer were obviously higher than those with benign lung disease and normal controls (p<0.01). The sensitivities of Hp, CEA, NSE and CYFRA21-1 were 43.5%, 40.9%, 23.3% and 41.5%, with specificities of 90.7%, 99.2%, 97.9% and 97.9%. Four tumor markers combined together could produce a positive detection rate of 85.0%, significantly higher than that of any single test. With squamous carcinomas, the positive detection rates with Hp and CYFRA21-1 were higher than that of other markers. In the adenocarcinoma case , the positive detection rate of CEA was higher than that of other markers. For small cell carcinomas, the positive detection rate of NSE was highest. The area under receiver operating characteristic curve (AUCROC) of Hp in squamous carcinoma (0.805) was higher than in adenocarcinoma (0.664) and small cell carcinoma (0.665).
Hp can be used as a new serum tumor marker for lung cancer. Combination detection of Hp, CEA, NSE and CYFRA21-1 could significantly improve the sensitivity and specificity in diagnosis of lung cancer, and could be useful for pathological typing.
探讨血清触珠蛋白（Hp）、癌胚抗原（CEA）、神经元特异性烯醇化酶（NSE）及细胞角蛋白19片段（CYFRA21-1）联合检测在肺癌中的临床应用价值。
采用免疫比浊法检测193例肺癌患者、87例肺部良性疾病患者及150例健康对照者血清Hp水平，采用化学发光法检测血清CEA、NSE、CYFRA21-1水平。比较各组间表达差异，并分析这些肿瘤标志物联合诊断肺癌的效果。
肺癌患者血清肿瘤标志物水平明显高于肺部良性疾病患者和正常对照者（p<0.01）。Hp、CEA、NSE及CYFRA21-1的敏感性分别为43.5%、40.9%、23.3%和41.5%，特异性分别为90.7%、99.2%、97.9%和97.9%。四项肿瘤标志物联合检测的阳性检出率为85.0%，显著高于单项检测。在鳞癌中，Hp和CYFRA21-1的阳性检出率高于其他标志物。在腺癌中，CEA的阳性检出率高于其他标志物。在小细胞肺癌中，NSE的阳性检出率最高。Hp在鳞癌中的受试者工作特征曲线下面积（AUCROC）（0.805）高于腺癌（0.664）和小细胞肺癌（0.665）。
Hp可作为一种新型的肺癌血清肿瘤标志物。联合检测Hp、CEA、NSE及CYFRA21-1可显著提高肺癌诊断的敏感性和特异性，并有助于病理分型。
