4种肿瘤标志物在肺癌病理分型、分期中的临床价值

摘要

目的：探讨CEA、SCC-Ag、NSE、CA125与肺癌病理分型以及临床特征之间的关系。方法：应用电化学发光方法检测109例肺癌患者血清中4种肿瘤标志物水平。结果：CEA在腺癌中的水平明显高于其他类型的肺癌（P＝0．003）；SCC-Ag在鳞癌中的水平明显高于其他类型的肺癌（P＝0．006）；NSE 在小细胞肺癌中的水平明显高于其他类型的肺癌（P＝0．001）。CEA在T3、T4分期表达的水平明显高于T1和T2分期（P＝0．041）。NSE和CA125在N2和N3期患者中表达水平明显高于N0和N1期患者（P＜0．05）。CEA在有远处转移的患者中表达水平明显高于无转移的患者（P＝0．038）。CEA和SCC-Ag转移部位越多，其表达越高（P＜0．05）。CEA在Ⅳb 期患者中表达水平明显高于Ⅰ＋Ⅱ＋Ⅲ和Ⅳa 期患者（P＝0．037）。CA125在有胸腔积液的患者中表达水平明显高于无胸腔积液的患者（P＝0．001）。结论：CEA对晚期腺癌的诊断价值较高， SCC-Ag是诊断鳞癌有价值的标志物，NSE对小细胞肺癌有较高的诊断价值。CEA与临床分期正相关，高表达预示分期晚，低表达则对分期参考作用小。CEA及SCC-Ag高浓度应高度警惕有无多部位转移，CA125水平高提示可能存在胸膜转移。%Objective:To assess the expression of serum CEA,SCC-Ag,NSE and CA125 in lung cancer of differ-ent pathology type and different clinical feature.Methods:Electrochemiluminescence method was applied to detect the expression of four serum tumor markers in 109 patients with lung caner.Results:The level of CEA in patients with ad-enocarcinoma was significantly higher than that of other subtype of lung cancer(P=0.003).The level of SCC-Ag in patients with squamous cell cancer was significantly higher than that of other subtype(P=0.006).The expression of NSE was significantly higher in small cell lung caner than other subtype (P=0.001).The level of CEA was higher in T3 and T4 than in T1 and T2(P=0.041).And the expression of CA125 and NSE was higher in N2 and N3 than in N0 and N1 (P<0.05).Furthermore,serum CEA had a higher expression in patients with distant metastasis than those without metastasis(P=0.038).The more metastasis sites the patients had,the higher levels serum CEA and SCC-Ag expressed(P<0.05).The expression of serum CEA was higher in stage ofⅣb than in stage ofⅠ,Ⅱ,ⅢandⅣa (P=0.037).The expression of serum CA125 was higher in patients with pleural effusion than those without pleural effusion(P=0.001).Conclusion:CEA is valuable tumor marker in diagnosis of adenocarcinoma.SCC-Ag is most valuable for diagnosis of squamous cell carcinoma.NSE is highly valuable for diagnosis of small cell lung cancer.CEA was positively related to clinical stage of lung cancer.High level predicts an advanced stage,while low level does not provide much information for determining the stage.The high level of CEA and SCC-Ag may indicate multi -site metastasis.High level of CA125 indicates metastasis to pleura.