[1]王 玲,申 鸿.癌胚抗原、糖类抗原、CA125、血管生成素、细胞角蛋白19片段及甲胎蛋白检测在肺癌诊断中的临床研究*[J].陕西医学杂志,2019,(8):1080-1084.
 WANG Ling,SHEN Hong..The value of tumor markers CEA,CA199,CA125,Ang-2,CYFRA211 and AFP in the diagnosis of lung cancer[J].,2019,(8):1080-1084.
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癌胚抗原、糖类抗原、CA125、血管生成素、细胞角蛋白19片段及甲胎蛋白检测在肺癌诊断中的临床研究*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年8期
页码:
1080-1084
栏目:
临床检验
出版日期:
2019-08-05

文章信息/Info

Title:
The value of tumor markers CEA,CA199,CA125,Ang-2,CYFRA211 and AFP in the diagnosis of lung cancer
文章编号:
DOI:10.3969/j.issn.1000-7377.2019.08.034
作者:
王 玲1申 鸿2
1.西安大兴医院检验科(西安 710016);2.西安交通大学医院检验科(西安 710061)
Author(s):
WANG Ling SHEN Hong.
Clinical Laboratory of Xi’an Daxing Hospital(Xi’an 710016)
关键词:
肺癌糖类抗原癌胚抗原促血管生成素-2 细胞角蛋白19片段抗原21-1甲胎蛋白诊断
Keywords:
Key words Lung cancerCarbohydrate antigenCarcinoembryonic antigenAngiopoietin-2Cytokeratin 19Fragment antigen 21-1Alpha-fetoprotein Diagnosis
分类号:
R737.31
文献标志码:
A
摘要:
摘 要 目的:探讨肿瘤标志物癌胚抗原(CEA)、糖类抗原(CA199)、CA125、血管生成素(Ang-2)、细胞角蛋白19片段(CYFRA211)及甲胎蛋白(AFP)在肺癌诊断中的价值。方法:回顾性分析确诊的74例肺癌(肺癌组)、76例良性病变者(良性组)及同期抽检的70例健康体检者(对照组)临床资料。对各组研究对象血清CEA、CA199、CA125、Ang-2、CYFRA211及AFP水平进行统计学分析。结果:肺癌组CEA、CA199、CA125、Ang-2、CYFRA211、AFP 检测水平均明显高于良性组和对照组(P<0.05),但对照组和良性组各指标检测水平间比较差异无统计学意义(P>0.05)。腺癌患者血清CEA、CA199、CA125、AFP检测水平均明显高于鳞癌及小细胞癌患者(P<0.05);小细胞癌患者血清Ang-2显著低于鳞癌及腺癌患者,而鳞癌血清CYFRA211水平明显高于腺癌和小细胞癌(P<0.05)。不同病理分期患者血清CEA、CA199、CA125、Ang-2、CYFRA211、AFP检测水平间比较差异均具有统计学意义(P<0.05),Ⅲ期检测水平明显高于Ⅰ和Ⅱ期,Ⅳ期明显高于Ⅲ期。CA125+CEA+CA199+Ang-2+CYFRA211+AFP 6项指标联合检测敏感性和准确度显著高于CA125+CEA+CA199+Ang-2、CA125+CEA+CA199+Ang-2+CYFRA211联合检测及各指标单项检测(P<0.05),但特异度未出现明显下降(P>0.05)。结论:血清CEA、CA199、CA125、Ang-2、CYFRA211及AFP对肺癌诊断、病理分期及组织学分型均具有重要意义,联合检测可明显提高肺癌诊断敏感性和准确度,但并不影响诊断特异性,因此可减少临床误诊、漏诊率发生。
Abstract:
Abstract Objective:To investigate the value of carcinoembryonic antigen (CEA),carbohydrate antigen (CA199),CA125,angiopoietin (Ang-2),cytokeratin 19 fragment (CYFRA211) and alpha fetoprotein (AFP) in the diagnosis of lung cancer.Methods:The clinical data of 74 cases of lung cancer (lung cancer group),76 cases of benign lesions (benign group) and 70 healthy subjects (control group) of the same period were analyzed .Serum CEA,CA199,CA125,Ang-2,CYFRA211 and AFP levels were statistically analyzed in each group.Results:The detection levels of CEA,CA199,CA125,Ang-2,CYFRA211 and AFP in lung cancer group were significantly higher than those in benign group and control group (P<0.05).However,there was no significant difference in the detection levels between the control group and the benign group (P>0.05).The serum levels of CEA,CA199,CA125 and AFP in patients with adenocarcinoma were significantly higher than those in squamous cell carcinoma and small cell carcinoma (P<0.05),the serum Ang-2 level of patients with small cell carcinoma was significantly lower than that of squamous cell carcinoma and adenocarcinoma,while the serum CYFRA211 level of squamous cell carcinoma was significantly higher than that of adenocarcinoma and small cell carcinoma (P<0.05). The serum levels of CEA,CA199,CA125,Ang-2,CYFRA211 and AFP in different pathological stages were statistically significant (P<0.05),and the level of phase III detection was significantly higher than that of stage I and II,and stage IV was significantly higher than stage III.The sensitivity and accuracy of the combined detection of CA125+CEA+CA199+Ang-2+CYFRA211+AFP were significantly〖LM〗 higher than that of CA125+CEA+CA199+Ang-2,CA125+CEA+CA199+Ang-2+CYFRA211 and each indicator (P<0.05),however,the specificity did not decrease significantly (P>0.05).Conclusion: Serum CEA,CA199,CA125,Ang-2,CYFRA211 and AFP have significant significance in the diagnosis,pathological staging and histological classification of lung cancer. Combined detection can significantly improve the sensitivity and accuracy of lung cancer diagnosis,but it does not affect the diagnostic specificity. Therefore,the incidence of clinical misdiagnosis and missed diagnosis is reduced.

参考文献/References:

[1] Molina R,Marrades RM,Auge JM,et al. Assessment of a Combinedp anel of six serum tumor markers for lung cancer [J]. Am J Respir Crit Care Med,2015,193(4):427-437.
[2] Spiridonidis CH,Laufman LR,Stydnicki KA,et al. Decline of posttreatment tumor marker levels after therapy of nonsmall cell lung cancer. A useful outcome predictor[J]. Cancer,2015,75(7):1586-1593.
[3] Xu C,Wang W,Wang Y,et al. Serum angiopoietin-2 as a clinicalmarker for lung cancer in patients with solitary pulmonary nodules[J]. Annals of Clinical & Laboratory Science,2016,46(1):60-64.
[4] 陈海珍,陈建国,蔡 晶,等. 南通市肿瘤医院2002-2014年启东和海门籍肺癌住院患者生存率分析[J]. 中国慢性病预防与控制,2017,25(6):436-439.
[5] 陈 玲,郑正涛,曾 奇,等. 珠海市2003-2010年原发性肺癌住院病例预后影响因素分析[J]. 中华肿瘤防治杂志,2014,21(10):736-739. 
[6] 再依奴尔·阿不都外力,赵 婷,刘志云,等. 2010-2014年新疆医科大学附属肿瘤医院住院病例主要恶性肿瘤生存分析[J]. 中华肿瘤防治杂志,2016,23(11):699-703. 
[7] Goldstraw P,Rami-Porta R,Asamura H,et al. The IASLC lung cancer staging project: proposals for revision of the TNM stage groupings in the forthcoming (Eighth) edition of the TNM classification for lung cancer[J]. Journal of Thoracic Oncology,2016,11(1):39-51.
[8] 夏万泓,刘大江,骆 伟. 128层螺旋 CT 诊断腹部段食管癌与贲门癌淋巴结转移临床价值研究[J]. 陕西医学杂志,2016,45(3):338-339.
[9] Jaques G,Auerbach B,Pritsch M,et al. Evaluation of serum neural cell adhesion molecule as a new tumor marker in small cell lung cancer[J]. Cancer,2015,72(2):418-425.
[10] Abtahi S,Malekzadeh M,Nikravan G,et al. Measurement of lung cancer tumor markers in a glass wool company workers exposed to respirable synthetic vitreous fiber and dust[J]. Int J Occup Environ Med,2018,9(1):23-31.
[11] 原永明,赵 莹,赵津晶,等. C 反应蛋白与4项肿瘤标志物联合检测在肺癌诊断中的意义[J]. 检验医学,2014,29(10):1053-1055.
[12] 朱 娜,彭建美,袁 军. CEA、AFP、CA-199和CA72-4联合检测在食管癌诊断中的价值[J]. 陕西医学杂志,2018,47(1):120-122.
[13] 陈阳阳,张 洁,徐国宾. 晚期肺癌患者一线化疗后6种血清肿瘤标志物水平的变化及意义[J]. 临床检验杂志,2015,33(2):124-129.
[14] Zeng YC,Wu R,Wang SL, et al. Serum CA125 level predicts prognosis in patients with multiple brain metastases from non-small cell lung cancer before and after treatment of whole-brain radiotherapy[J]. Med Onc,2014,31(7):48-52.
[15] Akac PK,Cileda A,Demir N,et al. Prognostic significance of serum vascular endothelial growth factor and Angiopoietin-2 in patients with lung cancer [J]. Tuberkuloz Ve Toraks,2015,63(2):71-77.
[16] 雷程琳,卢家兴. 血清肿瘤标志物AFP、CYFRA21-1、NSE对肺癌的诊断及预后价值研究[J]. 国际检验医学杂志,2018,39(4):458-461.
[17] Jiang ZF,Wang M,Xu JL. Thymidine kinase 1 combined with CEA,CYFRA21-1 and NSE improved its diagnostic value for lung cancer[J]. Life Sciences,2018,194(3):1-6.

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备注/Memo

备注/Memo:
*陕西省社会发展攻关项目(2012K19-01)
更新日期/Last Update: 2019-08-13