【摘要】 目的:本文选用CEA、CA125、CA50、CA19-9、CA153、CYFRA21-1等6种肿瘤标志物,探讨单项及组合检测对肺癌诊断的临床价值。方法:采用R IA法。结果:①40例肺良性疾病中仅CA125及CA153两组各发现1例阳性,与相应肺癌组经统计学处理呈显著性差异(P<0.001)。②肺癌组单项检测阳性率以CYFRA21-1最高达79.23%,最低为CA50为43.84%,依次为CYFRA21-1(79.23%)>CA153(61.53%)>CA125(58.46%)>CA19-9(57.69%)>CEA(46.92%)>CA50(43.84%)。③6种肿瘤标志物检测以CYFRA21-1为主,组合其它5项之一联合检测均可使单项组合检测阳性率分别提高到86.15%~89.23%。④良、恶性肺疾病患者组6项检测均值对比,肺癌组均值高于良性疾病组4倍以上。表明其对肺癌诊断的可信度较大。⑤本文对组织学分类确诊的108例鳞、腺癌分析,除CA199鳞、腺癌阳性率经统计学处理具显著性差异(P<0.001)外,其余组间未见差异。结论:笔者认为,6种肿瘤标志物对肺癌诊断均有一定的临床价值,单项以CYFRA21-1为首选,组合检测以CYFRA21-1+CA153或CA125/CA19-9为佳。更多还原

【Abstract】 Objective To study the clinical applicability of single/combined determination of six tumor markers(CEA,CA125,CA50,CA19-9,CA153,CYFRA21-1) for diagnosis of pulmonary carcinoma.Methods Serum contents of these six tumor markers were determined with RIA in 130 patients with pulmonary carcinoma,40 patients with various benign pulmonary disorders,and 45 controls.Results ① Only two false positive cases were found in the 40 patients with benign pulmonary disorders(CA125,n=1,CA153 n=1).② Positive rate of single marker in patients with pulmonary cancer: CYFRA21-1(79.23%)>CA153(61.53%)>CA125(58.46%)>CA19-9(57.69%)>CEA(46.92%)>CA50(43.84%).③ Combined determination of CYFRA21-1 with any one of the other 5 markers would increase the positive rate to 86.15%~89.23%.④ Mean value of any marker in the malignant cases were over 4 folds of that in the benign cases——high diagnostic credibility.⑤ Histology of the malignancy(squamous cell carcinoma or adenocarcinoma) made no difference on the positive rate of the markers with the exception of a slight higher positive rate of CA19-9 in adenocarcinomas.Conclusion The authors believe that combined determination of CYFRA21-1 with CA153 would be the first choice for diagnosis of pulmonary carcinoma,followed by CYFRA21-1+CA125 or CA19-9.更多还原