血清p53抗体联合CEA、CYFRA21-1检测在肺癌诊断中的价值

摘要

目的 探讨联合检测肺癌患者血清p53抗体与癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)辅助肺癌诊断的可行性.方法 在57例肺癌(肺癌组)和40例肺部良性疾病患者(对照组),采用ELISA法检测血清p53抗体,采用电化学发光免疫分析法检测血清CEA和CYFRA21-1.结果 肺癌组血清p53抗体、CEA和CYFRA21-1水平均高于对照组(P＜0.05).p53抗体、CEA、CYFRA21-1曲线下面积(AUC)分别为0.770、0.814、0.779.p53抗体、CEA和CYFRA21-1的诊断界点分别为1.150 U/ml、3.095 ng/ml、3.240 ng/ml,敏感性分别为45.61％、66.67％、68.42％,特异性分别为87.50％、87.50％、85.00％.三项联合检测的AUC为0.902,敏感性为89.47％,特异性为100％.CEA与CYFAR21-1呈正相关(r=0.555,P＜0.05).结论 血清p53抗体为独立的肺癌生物标记物,与CEA、CYFRA21-1联合检测有助于提高肺癌诊断水平.%Objective To explore the value of combined detection of serum anti-p53 antibody with carcinoembryonic antigen(CEA) and CYFRA21-1 in the diagnosis of lung cancer. Methods In 57 patients with lung cancer (group A) and 40 patients with benign pulmonary diseases (group B), serum levels of anti-p53 antibody, CEA and CYFRA 21-1 were measured by ELISA and electro-chemiluminescence immunoassay. Results Serum levels of anti-p53 antibody, CEA and CYFRA21-1 were higher in group A than those in group B(P<0. 05). The values of receiver operating characteristic area under the curve(AUC) for anti-p53 antibody,CEA and CYFRA 21-1 were 0. 770, 0. 814 and 0. 779, respectively. The cutoff levels of anti-p53 antibody, CEA and CYFRA 21-1 were 1. 150 U/ml,3. 095 ng/ml and 3. 240 ng/ml, respectively. The sensitivities of those markers for lung cancer detection were 45. 61%,66. 67%, 68. 42%, while the specificities were 87. 50%, 87. 50% and 85. 00% respectively. The value of AUC, sensitivity and specificity were 0. 90, 89. 47% and 100%, respectively,when combined detection of the three markers was performed. Serum level of CEA was positively correlated to that of CYFRA 21-1 (r=0. 555, P<0. 05). Conclusion Anti-p53 antibody is an independent biomarker of lung cancer. Combined analysis of serum anti-p53 antibody, CEA and CYFRA21-1 can improve the diagnosis of lung cancer.