淀粉样蛋白A联合肿瘤标志物对肺癌诊断的应用
摘要
目的探讨淀粉样蛋白A(SAA)联合肿瘤标志物检测对肺癌诊断的应用价值。方法选取2017年9月—2018年9月在本院住院治疗的240例疑似肺癌患者作为研究对象,分为肺癌组160例,良性肺病组80例;另选取同期健康体检者100名作为健康对照组。采用酶免疫化学发光法对所选对象癌胚抗原(CEA)进行检测,采用化学发光法对鳞状上皮细胞癌抗原(SCC)、糖类抗原125(CA125)、糖类抗原199(CA199)和血清细胞角蛋白19片段(CYFRA21-1)进行检测。采用酶联免疫吸附法对SAA进行测定。结果肺癌组患者血清CEA、SCC、CA199和CYFRA21-1表达水平均明显高于良性肺病组及健康对照组,差异均具有统计学意义(P<0.05);血清CA125水平的表达,肺癌组>良性肺病组>健康对照组,具有显著性差异(P<0.05)。血清CA125对肺癌诊断的敏感度最高,而特异度最低,具有显著性差异(P<0.05); SAA联合CA125、CA199、SCC、和CYFRA21-1检测会明显提高肺癌诊断的敏感度,具有显著性差异(P<0.05)。结论 SAA联合CA125、CA199、SCC和CYFRA21-1检测可以提高肺癌诊断的特异度和灵敏度。
引文
[1]Dai S,Wang X,Liu L,et al.Discovery and identification of Serum Amyloid A protein elevated in lung cancer serum[J].China C Life Sci,2007,50(3):305-311.
[2]Ma L,Xie XW,Wang HY,et al.Clinical Evaluation of Tumor Markers for Diagnosis in Patients with Non-small Cell Lung Cancer in China[J].Asian Pac J Cancer Prev,2015 16(12):4891-4894.
[3]中华医学会呼吸病学分会肺癌学组.原发性支气管肺癌早期诊断中国专家共识(草案)[J].中华结核和呼吸杂志,2014,37(3):172-176.
[4]姚晓军,刘伦旭.肺癌的流行病学及治疗现状[J].现代肿瘤医学,2014,22(8):1982-1986.
[5]王姣平.肺癌早期诊断中多项肿瘤标记物的联合应用价值[J].中国老年学杂志,2014,34(6):1663-1664.
[6]Marks LB,Bentzen SM,Deasy JO,et al.Radiation dose-volume effects in the lung[J].Int J Radiat Oncol Biol Phys,2010,76(3):s70-s76.
[7]Kanoh Y,Abe T,Masuda N,et al.Progression of non-small cell lung cancer:diagnostic and prognostic utility of matrix metalloproteinase-2,C-reactive protein and serum amyloid A[J].Oncol Rep,2013,29(2):469-473.
[8]Zhi W,Ferris D,Sharma A,et al.Twelve serum proteins progressively increase with disease stage in squamous cell cervical cancer patients[J].Int J Gynecol Cancer,2014,24(6):1085-1092.
[9]Sung HJ,Ahn JM,Yoon YH,et al.Identification and validation of SAA as a potential lung cancer biomarker and its involvement in metastatic pathogenesis of lung cancer[J].J Proteome Res,2011,10(3):1383-1395.
[10]Tamamoto T,Ohno K,Goto-Koshino Y,et al.Serum amyloid Apromotes invasion of feline mammary carcinoma cells[J].J Vet Med Sci,2014,76(8):1183-1188.
[11]Hultén C,Demmers S.Serum amyloid A(SAA)as an aid in the management of infectious disease in the foal:comparison with total leucocyte count,neutrophil count and fibrinogen[J].Equine Vet J,2002,34(7):693-698.
[12]Im HJ,Koh KN Seo JJ.Haploidentical hematopoietic stem cell transplantation in children and adolescents with acquired severe aplastic anemia[J].Korean J Pediatr,2015,58(6):199-205.
[13]Leng P,Qiao F,Yu R,et al.The value of cobined detection of four serum tumor markers in the diagnosis of lung cancer[J].J Chen Med Coll,2015,12(4):41-44.
[14]Khan AM,Manzoor K,Jain V,et al.Detection of nodular pulmonary amyloid by PET positive scan-deception for lung cancer[J].Rev Port Pneumol,2012 18(6):299-303.
[15]廖贵莉,张月霞,许秀军.血清淀粉样蛋白A联合肿瘤标志物检测在肺癌中的应用[J].国际检验医学杂志,2016,37(24):3500-3501.
[16]刘凤霞.肿瘤标志物检验在肺癌诊断中的临床价值[J].中国医药科学,2014,2(2):107-108.
[17]吴杰,骆骥才,张钧,等.CEA、CA125、NSE、CYFRA21-1、SCC联合应用诊断肺癌的意义[J].临床检验杂志,2011,29(7):535-537.
[18]李宏宇,李沛,蔡三立,等.血清CEA、NSE、CYFRA21-1在肺癌诊治及预后判断中的临床价值[J].中国老年学杂志,2015,35(22):6458-6459.
[19]董梅,匡铁吉,杨彩娥,等.急性期反应蛋白与传染性非典型肺炎患者病情的相关性调查[J].中华检验医学杂志,2004,72(5):292.
[20]Liu DH,Wang XM,Zhang LJ,et al.Serum amyloid A protein:a potential biomarker correlated with clinical stage of lung cancer[J].Biomed Environ Sci,2007,20(1):33-40.
[21]de Lima Araujo LH,Pinto LW,Schluckebier LF et al.Amyloidlike fibrils are not detected in non-small cell lung cancer tissue samples[J].Med Oncol,2012,29(2):614-617.
[22]Zhang XY,Zhang G,Jiang Y,et al.The prognostic value of serum C-reactive protein-bound serum amyloid A in early-stage lung cancer[J].Chin J Cancer,2015,34:335-349.
[2]Ma L,Xie XW,Wang HY,et al.Clinical Evaluation of Tumor Markers for Diagnosis in Patients with Non-small Cell Lung Cancer in China[J].Asian Pac J Cancer Prev,2015 16(12):4891-4894.
[3]中华医学会呼吸病学分会肺癌学组.原发性支气管肺癌早期诊断中国专家共识(草案)[J].中华结核和呼吸杂志,2014,37(3):172-176.
[4]姚晓军,刘伦旭.肺癌的流行病学及治疗现状[J].现代肿瘤医学,2014,22(8):1982-1986.
[5]王姣平.肺癌早期诊断中多项肿瘤标记物的联合应用价值[J].中国老年学杂志,2014,34(6):1663-1664.
[6]Marks LB,Bentzen SM,Deasy JO,et al.Radiation dose-volume effects in the lung[J].Int J Radiat Oncol Biol Phys,2010,76(3):s70-s76.
[7]Kanoh Y,Abe T,Masuda N,et al.Progression of non-small cell lung cancer:diagnostic and prognostic utility of matrix metalloproteinase-2,C-reactive protein and serum amyloid A[J].Oncol Rep,2013,29(2):469-473.
[8]Zhi W,Ferris D,Sharma A,et al.Twelve serum proteins progressively increase with disease stage in squamous cell cervical cancer patients[J].Int J Gynecol Cancer,2014,24(6):1085-1092.
[9]Sung HJ,Ahn JM,Yoon YH,et al.Identification and validation of SAA as a potential lung cancer biomarker and its involvement in metastatic pathogenesis of lung cancer[J].J Proteome Res,2011,10(3):1383-1395.
[10]Tamamoto T,Ohno K,Goto-Koshino Y,et al.Serum amyloid Apromotes invasion of feline mammary carcinoma cells[J].J Vet Med Sci,2014,76(8):1183-1188.
[11]Hultén C,Demmers S.Serum amyloid A(SAA)as an aid in the management of infectious disease in the foal:comparison with total leucocyte count,neutrophil count and fibrinogen[J].Equine Vet J,2002,34(7):693-698.
[12]Im HJ,Koh KN Seo JJ.Haploidentical hematopoietic stem cell transplantation in children and adolescents with acquired severe aplastic anemia[J].Korean J Pediatr,2015,58(6):199-205.
[13]Leng P,Qiao F,Yu R,et al.The value of cobined detection of four serum tumor markers in the diagnosis of lung cancer[J].J Chen Med Coll,2015,12(4):41-44.
[14]Khan AM,Manzoor K,Jain V,et al.Detection of nodular pulmonary amyloid by PET positive scan-deception for lung cancer[J].Rev Port Pneumol,2012 18(6):299-303.
[15]廖贵莉,张月霞,许秀军.血清淀粉样蛋白A联合肿瘤标志物检测在肺癌中的应用[J].国际检验医学杂志,2016,37(24):3500-3501.
[16]刘凤霞.肿瘤标志物检验在肺癌诊断中的临床价值[J].中国医药科学,2014,2(2):107-108.
[17]吴杰,骆骥才,张钧,等.CEA、CA125、NSE、CYFRA21-1、SCC联合应用诊断肺癌的意义[J].临床检验杂志,2011,29(7):535-537.
[18]李宏宇,李沛,蔡三立,等.血清CEA、NSE、CYFRA21-1在肺癌诊治及预后判断中的临床价值[J].中国老年学杂志,2015,35(22):6458-6459.
[19]董梅,匡铁吉,杨彩娥,等.急性期反应蛋白与传染性非典型肺炎患者病情的相关性调查[J].中华检验医学杂志,2004,72(5):292.
[20]Liu DH,Wang XM,Zhang LJ,et al.Serum amyloid A protein:a potential biomarker correlated with clinical stage of lung cancer[J].Biomed Environ Sci,2007,20(1):33-40.
[21]de Lima Araujo LH,Pinto LW,Schluckebier LF et al.Amyloidlike fibrils are not detected in non-small cell lung cancer tissue samples[J].Med Oncol,2012,29(2):614-617.
[22]Zhang XY,Zhang G,Jiang Y,et al.The prognostic value of serum C-reactive protein-bound serum amyloid A in early-stage lung cancer[J].Chin J Cancer,2015,34:335-349.