【摘要】 目的观察纤维支气管镜检查联合肿瘤标记物检测对肺癌的诊断价值。方法对96例肺癌患者和88例肺部良性病变患者行纤维支气管镜检查和电化学发光法检测血清或胸水肿瘤标记物癌胚抗原(CEA)、糖链抗原125(CA125)及细胞角蛋白19片段(CYFRA21-1)水平。结果肺癌患者血清CEA、CA125及CYFRA21-1水平分别为(46.34±18.28)ng/mL、(83.34±33.26)U/mL及(25.67±10.32)ng/mL,高于肺部良性病变患者血清上述肿瘤标记物水平分别为(3.21±2.74)ng/mL、(38.75±18.43)U/mL及(1.67±1.46)ng/mL,P<0.05;36例伴有胸腔积液的肺癌患者胸水中CEA、CA125及CYFRA21-1水平分别为(76.23±31.64)ng/mL、(319.61±102.78)U/mL及(78.42±25.39)ng/mL,高于血清中上述肿瘤标记物水平分别为(51.42±12.26)ng/mL、(123.34±28.57)U/mL及(27.43±8.63)ng/mL,P<0.05。96例肺癌患者中纤维支气管镜检查确诊58例,敏感度为60.4%,特异度和准确度分别为100.0%和79.4%;CEA敏感度37.5%,特异度和准确度分别为87.5%和63.6%;CA125敏感度67.7%,特异度和准确度分别为40.9%和54.9%;CYFRA21-1敏感度56.3%,特异度和准确度分别为81.8%和68.5%。纤维支气管镜联合肿瘤标记物检测后敏感度为90.6%,特异度和准确度分别为92.0%和91.3%。结论纤维支气管镜检查联合肿瘤标记物检测,可以提高肺癌的诊断率。更多还原

【Abstract】 Objective To investigate the diagnosis value of fibro-optic-bronchoscope combined with tumor maker determination to lung cancer. Methods By fibro-optic bronchoscope (FB) and electrochemiluminescence (ECL) examinations, 98 cases with lung cancer and 88 cases with benign lung disease were studied for calculating the detectable sensitivity and specificity to lung cancer, then further for evaluating the clinical value of FB examination combined with detection of tumor marker in serum/pleural fluid of patients with lung cancer. Results In patients with lung cancer, the serum levels of CEA, CA125 and CYFRA21-1 were (46.34±18.28) ng/mL, (83.34±33.26) U/mL and (25.67±10.32) ng/mL respectively, which were higher than those in patients with benign lung diseases. The serum levels of above three tumor markers in patients with lung cancer all were significantly higher than those in patients with benign lung diseases (P<0.05). In the 36 specimens of pleural fluid, three tumor markers were higher than those in the corresponding serum samples. The detectable sensitivity of each tumor marker in pleural fluid was higher than that in serum. The sensitivity, specificity and overall accuracy of CEA in lung cancer were 37.5%、87.5% and 63.6% respectively, of CA125 were 67.7%, 40.9% and 54.9%; of CYFRA21-1 were 56.3%, 81.8% and 68.5%; of FB were 60.4%, 100.0% and 79.4% respectively. The sensitivity, specificity or overall accuracy of fibro-optic bronchoscope combined with tumor marker (TM) examination to diagnosis of lung cancer was 90.6%, 92.0% or 91.3% respectively. Conclusion The FB examination is valuable in diagnosing lung cancer, and by combined with TM determination, can further improve the accuracy to diagnosis of lung cancer.更多还原