血清肿瘤标志物CEA、CA125、CYFRA21-1在支气管肺癌诊断、病理类型及TNM分期中的价值分析
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摘要
目的探讨癌胚抗原(CEA)、糖类抗原(CA125)、细胞角蛋白19片段(CYFRA21-1)在肺癌诊断、病理类型及TNM分期中的应用价值。方法收集2017年1月至2018年4月入住唐都医院的288例患者的临床资料,采用电化学免疫荧光发光法检测血清肿瘤标志物的浓度,分析CEA、CA125、CYFRA21-1与肺癌诊断、病理类型及TNM分期的关系。结果肺癌组CEA、CA125、CYFRA21-1血清表达水平高于肺部良性病变组,P<0.05。单个肿瘤标志物在区分肺癌不同病理类型时,CYFRA21-1诊断价值最高。在肺癌不同TNM分期中,CEA、CA125阳性率随着肿瘤分期逐渐升高,各分期之间阳性率存在统计学意义,P<0.05。CYFRA21-1其阳性率随分期变化逐渐升高,但各组间无统计学意义,P>0.05。结论 CEA、CA125、CYFRA21-1在肺癌诊断价值中有意义,在不同病理类型中CYFRA21-1诊断价值较大,CEA、CA125、CYFRA21-1在肺癌TNM分期中诊断价值不同,利用血清肿瘤标志物进行TNM分期,可为病理TNM分期提供参考。
Objective To evaluate the application of CEA,CA125 and cytokeratin 19 fragments( CYFRA21-1) in the diagnosis,pathological types and TNM stages of lung cancer. Methods It was collected288 cases of hospitalized patients clinical data in Tang Du hospitals between January 2017 and April 2018. The concentrations of tumor markers in serum were detected by electrochemical immunofluorescence.It was analyzed the relationship between CEA,CA125 and CYFRA21-1 which were about lung cancer diagnosis,pathological types and TNM stages. Results Serum levels of CEA,CA125 and CYFRA21-1 in the lung cancer group were higher than those in the benign lung lesions group. CYFRA21-1 is the most valuable single tumor marker in different pathological types of lung cancer. The positive rates and serum levels of CEA and CA125 were of high application value in different TNM stages of lung cancer. Serum levels of CEA,CA125 and CYFRA21-1 are of great value in the early and late differentiation of lung cancer. Conclusion The CEA,CA125 and CYFRA21-1 are significant in the diagnosis of lung cancer. Among different pathological types,CYFRA21-1 is of great diagnostic value. The CEA,CA125 and CYFRA21-1 have different diagnostic values in TNM stage of lung cancer.
Objective To evaluate the application of CEA,CA125 and cytokeratin 19 fragments( CYFRA21-1) in the diagnosis,pathological types and TNM stages of lung cancer. Methods It was collected288 cases of hospitalized patients clinical data in Tang Du hospitals between January 2017 and April 2018. The concentrations of tumor markers in serum were detected by electrochemical immunofluorescence.It was analyzed the relationship between CEA,CA125 and CYFRA21-1 which were about lung cancer diagnosis,pathological types and TNM stages. Results Serum levels of CEA,CA125 and CYFRA21-1 in the lung cancer group were higher than those in the benign lung lesions group. CYFRA21-1 is the most valuable single tumor marker in different pathological types of lung cancer. The positive rates and serum levels of CEA and CA125 were of high application value in different TNM stages of lung cancer. Serum levels of CEA,CA125 and CYFRA21-1 are of great value in the early and late differentiation of lung cancer. Conclusion The CEA,CA125 and CYFRA21-1 are significant in the diagnosis of lung cancer. Among different pathological types,CYFRA21-1 is of great diagnostic value. The CEA,CA125 and CYFRA21-1 have different diagnostic values in TNM stage of lung cancer.
引文
1钱桂生.肺癌不同病理类型发病率的变化情况及原因[J/CD].中华肺部疾病杂志(电子版),2011,4(1):1-6.
2 Siegel RL,Miller KD,Jemal A,et al.Cancer statistics,2015[J].CA Cancer J Clin,2015,65(1):5-29.
3 Kejík Z,Bríza T,KrálováJ,et al.Selective recognition of a saccharide-type tumor marker with natural andsyntheticlig-ands:anewtrend in can ncrdiagnosis[J].Anal Bioanal Chem,2010,398(5):1865-1870.
4赵肖,王孟昭.肺癌血清肿瘤标志物的临床意义[J].中国肺癌杂志,2011,14(3):286-291.
5陈超,赵岚,王银,等.五种血清肿瘤标志物检测在肺癌临床诊断中的意义[J].中国实验诊断学,2016,(11):1853-1856.
6钱明,袁君君,林赛玲,等.CA125在肺癌的诊断分型及分期中的应用[J].中国医疗前沿,2017,6(12):58-64.
7 Holdenr IE,Wehnl B,Hettwer K,et al.Carcinoembryonic antigen and cytokeratin-19 fragments for assessment of therapy response in non-small cell lung cencer:a systematic review and meta-analysis[J].Br J Cancer,2017,116(8):1037-1045.
8 Zhao W,Yu H,Han Z,et al.Clinical significance of joint detection of serum CEA,SCCA,and bFGF in the diagnosis of lung cancer[J].inter J Clin,2015,8(8):9506-9511.
9 Hirose T,Okuda K,Yamaoka T,et al.Are levels of pro-gastrinreleasing peptide or neuron-specific enolase at relapse prognostic factors after relapse in patients with small-cell lung cancer[J].Lung Cancer,2011,71:224-228.
10 Bates J,Ru therford M,Divilly M,et al.Clinical value of CYFRA21-1,carcinoem brvonic:antigen and tissue polypeptide antigen in the diagnosis of lung cancer[J].Eur Respir J,1997,10(11):2535-3538.
11王忠颖.CA125、CA153、CA199、CEA联合检测对肺癌与肺结核的鉴别诊断价值[J].国际医药卫生导报,2016,22(9):1297-1299.
12刘苗苗,南岩东,陈艳丽,等.血清肿瘤标志物和自身抗体与肺癌患者临床病理特征的相关性研究[J/CD].中华肺部疾病杂志(电子版),2018,11(2):176-181.
13王爱红,王明全,周小燕.血清肿瘤标志物对于原发性支气管肺癌病理类型的判别分析[J].中国医药导报,2017,14(23):67-70.
14 Zhang L,Liu D,Li L,et al.The important role of circulating CYFRA21-1 in metastasis diagnosis and prognostic value compared with carcinoembryonic antigen and neuron-specific enolase in lung cancer patients[J].BMC Cancer,2017,17(1):96.
15 Li Y,Li X,Shi G,et al.Application value of joint detection of serum marker CYFRA21-1,NES,CEA,CA19-9,CA125,SCC in diagnosis of lung cancer[J].Acta Med,2016,32(1):1671-1674.
16李慧,陈艳乐,常静侠,等.肿瘤标志物在肺癌诊断、病理分型和临床分期中的价值[J/CD].中华肺部疾病杂志(电子版),2013,6(2):144-148.
17 Song WA,Liu X,Tian XD,et al.Utility of squamous cell carcinoma antigen,carcinoembryonic antigen,Cyfra 21-1 and neuron specific enolase in lung cancer diagnosis:a prospective study from China[J].Chin Med J,2011,124(20):3244-3248.
18李利英,武云利,李双平.血清肿瘤标志物在肺癌TNM分期中的价值研究[J].临床和实验医学杂志,2017,16(13):1309-1312.
19刘源源,方申存.血清肿瘤标志物在慢性阻塞性肺病中的临床意义[J/CD].中华肺部疾病杂志(电子版),2016,9(4):391-395.
20殷和,王琼,金发光.多种肿瘤标志物检测在肺癌辅助诊断中的价值[J/CD].中华肺部疾病杂志(电子版),2016,9(3):271-274.
2 Siegel RL,Miller KD,Jemal A,et al.Cancer statistics,2015[J].CA Cancer J Clin,2015,65(1):5-29.
3 Kejík Z,Bríza T,KrálováJ,et al.Selective recognition of a saccharide-type tumor marker with natural andsyntheticlig-ands:anewtrend in can ncrdiagnosis[J].Anal Bioanal Chem,2010,398(5):1865-1870.
4赵肖,王孟昭.肺癌血清肿瘤标志物的临床意义[J].中国肺癌杂志,2011,14(3):286-291.
5陈超,赵岚,王银,等.五种血清肿瘤标志物检测在肺癌临床诊断中的意义[J].中国实验诊断学,2016,(11):1853-1856.
6钱明,袁君君,林赛玲,等.CA125在肺癌的诊断分型及分期中的应用[J].中国医疗前沿,2017,6(12):58-64.
7 Holdenr IE,Wehnl B,Hettwer K,et al.Carcinoembryonic antigen and cytokeratin-19 fragments for assessment of therapy response in non-small cell lung cencer:a systematic review and meta-analysis[J].Br J Cancer,2017,116(8):1037-1045.
8 Zhao W,Yu H,Han Z,et al.Clinical significance of joint detection of serum CEA,SCCA,and bFGF in the diagnosis of lung cancer[J].inter J Clin,2015,8(8):9506-9511.
9 Hirose T,Okuda K,Yamaoka T,et al.Are levels of pro-gastrinreleasing peptide or neuron-specific enolase at relapse prognostic factors after relapse in patients with small-cell lung cancer[J].Lung Cancer,2011,71:224-228.
10 Bates J,Ru therford M,Divilly M,et al.Clinical value of CYFRA21-1,carcinoem brvonic:antigen and tissue polypeptide antigen in the diagnosis of lung cancer[J].Eur Respir J,1997,10(11):2535-3538.
11王忠颖.CA125、CA153、CA199、CEA联合检测对肺癌与肺结核的鉴别诊断价值[J].国际医药卫生导报,2016,22(9):1297-1299.
12刘苗苗,南岩东,陈艳丽,等.血清肿瘤标志物和自身抗体与肺癌患者临床病理特征的相关性研究[J/CD].中华肺部疾病杂志(电子版),2018,11(2):176-181.
13王爱红,王明全,周小燕.血清肿瘤标志物对于原发性支气管肺癌病理类型的判别分析[J].中国医药导报,2017,14(23):67-70.
14 Zhang L,Liu D,Li L,et al.The important role of circulating CYFRA21-1 in metastasis diagnosis and prognostic value compared with carcinoembryonic antigen and neuron-specific enolase in lung cancer patients[J].BMC Cancer,2017,17(1):96.
15 Li Y,Li X,Shi G,et al.Application value of joint detection of serum marker CYFRA21-1,NES,CEA,CA19-9,CA125,SCC in diagnosis of lung cancer[J].Acta Med,2016,32(1):1671-1674.
16李慧,陈艳乐,常静侠,等.肿瘤标志物在肺癌诊断、病理分型和临床分期中的价值[J/CD].中华肺部疾病杂志(电子版),2013,6(2):144-148.
17 Song WA,Liu X,Tian XD,et al.Utility of squamous cell carcinoma antigen,carcinoembryonic antigen,Cyfra 21-1 and neuron specific enolase in lung cancer diagnosis:a prospective study from China[J].Chin Med J,2011,124(20):3244-3248.
18李利英,武云利,李双平.血清肿瘤标志物在肺癌TNM分期中的价值研究[J].临床和实验医学杂志,2017,16(13):1309-1312.
19刘源源,方申存.血清肿瘤标志物在慢性阻塞性肺病中的临床意义[J/CD].中华肺部疾病杂志(电子版),2016,9(4):391-395.
20殷和,王琼,金发光.多种肿瘤标志物检测在肺癌辅助诊断中的价值[J/CD].中华肺部疾病杂志(电子版),2016,9(3):271-274.