【摘要】 目的:评价外周血CK-19 mRNA与肿瘤标志物癌胚抗原(CEA)、神经元特异性烯醇酶(NSE)和细胞角蛋白19血清片段21-1(CYFRA21-1)联合检测对肺癌临床诊断的价值和意义。方法:分别应用RT-PCR与放射免疫分析法、免疫放射分析法测定64例肺癌患者、40例肺部良性疾病患者和30例健康人CK-19 mRNA、CEA、NSE和CYFRA21-1的表达情况,并分析它们在不同临床病理类型和不同分期肺癌患者中的表达和联合检测的灵敏度、特异度和准确性。结果:肺癌患者CK-19 mRNA、CEA、NSE和CYFRA21-1的阳性率均高于肺部良性疾病组和健康对照组。不同病理类型的肺癌组织中CK-19 mRNA阳性率差异无统计学意义,Ⅰ-Ⅱ期、Ⅲ期、Ⅳ期肺癌组织中CK-19mRNA的阳性率呈明显的上升趋势。肺鳞癌组织中CYFRA21-1的阳性率最高(78.5%),小细胞肺癌组织中NSE的阳性率最高(81.3%),肺腺癌组织中CEA的阳性率最高(79.2%)。4者联合检测灵敏度和准确性为90.6%和86.2%。结论:肺癌患者外周血CK-19 mRNA和肿瘤标记物CEA、NSE、CYFRA21-1联合检测可提高肺癌的诊断率,并可为肺癌病理类型的诊断提供重要的参考。更多还原

【Abstract】 Aim:To evaluate the significance of combined detection of CK-19 mRNA,CEA,NSE,and CYFRA21-1 in clinical diagnosis of lung carcinoma.Methods:Based on RT-PCR,radio immunoassay and immunoradiometric assay,the expression levels of CK-19 mRNA,CEA,NSE and CYFRA21-1 of 64 case of lung carcinoma,40 case of benign pneumonopathy and 30 healthy participants were detected respectively;meantime we also examined the sensitivity,specificity,accuracy of combination detection.Results:The positive rate of CK-19 mRNA in peripheral blood and CEA,NSE,CYFRA21-1 in serum were significantly higher than those in benign pneumonopathy and healthy participants group.There was no statistical significance when positive rate of CK-19 mRNA was evaluated in different pathological types.The positive rate of CK-19 mRNA in stageⅠ+Ⅱ,Ⅲ,and Ⅳ had an increasing tendency,the positive rate of CYFRA21-1 was highest in squamous carcinoma(78.5%),positive rate of NSE was highest in small cell carcinoma(81.3%),and positive rate of CEA was highest in lung adenocarcinoma(79.2%).Sensitivity and accuracy of combination detection were 90.6% and 86.2%.Conclusion:The combined detection of CK-19 mRNA,and tumor markers CEA,NSE,CYFRA21-1 in peripheral blood of patients with lung carcinoma was helpful to make more exact diagnosis,in addition,it also provides an important basis to differentiate pathological types of lung carcinoma.更多还原