Marel M, Bíbrová L, Melínová L, Potocková L, Svandová E
Pneumologická klinika 1. LF UK, Praha.
Cas Lek Cesk. 1993 Feb 22;132(4):108-12.
In groups of 50 patients with lung cancer and 19 patients with non-tumourous pulmonary disease the authors evaluated the contribution of examinations using four tumour markers (carcinoembryonic antigen, beta sub-unit of human choriogonadotropin, neuron-specific enolase and alpha-l-fetoprotein) for statistically significant differences were found only in CEA; NSE and HCG levels were higher in patients with tumours, the differences were, however, not statistically higher in patients with non-tumorous diagnoses. The levels of tumour marker rose in relation to TNM stages. When evaluating tumour markers in relation to histological types of lung cancer, the authors found the highest CEA levels in adenocarcinomas, HCG in the non-differentiated type and NSE were highest in small-cell lung cancer. By means of a mathematical model of discrimination analysis the optimal combination of discrimination signs was defined which was age, CEA and HCG. With the help of the elaborated equation it is possible to differentiate on the basis of our results groups of patients with an almost 80% certainty. The authors conclude that tumour markers are not suitable for screening patients with lung cancer; they can be successfully used as auxiliary diagnostic methods at pneumological and oncological in-patient departments.
作者对50例肺癌患者和19例非肿瘤性肺部疾病患者进行分组,评估了使用四种肿瘤标志物(癌胚抗原、人绒毛膜促性腺激素β亚基、神经元特异性烯醇化酶和甲胎蛋白)检查的作用。结果发现,仅癌胚抗原存在统计学显著差异;肿瘤患者的神经元特异性烯醇化酶和人绒毛膜促性腺激素水平较高,但非肿瘤诊断患者的差异无统计学意义。肿瘤标志物水平随TNM分期升高。在评估与肺癌组织学类型相关的肿瘤标志物时,作者发现腺癌患者的癌胚抗原水平最高,未分化型患者的人绒毛膜促性腺激素水平最高,小细胞肺癌患者的神经元特异性烯醇化酶水平最高。通过判别分析的数学模型,确定了判别指标的最佳组合,即年龄、癌胚抗原和人绒毛膜促性腺激素。借助精心推导的方程,根据我们的结果能够以近80%的确定性区分患者组。作者得出结论,肿瘤标志物不适用于肺癌患者的筛查;它们可作为呼吸科和肿瘤科住院部的辅助诊断方法成功使用。