VEGF联合CEA应用晚期NSCLC恶性胸腔积液临床价值探讨

摘要

目的探讨血管内皮生长因子(Vascular endothelial growth factor,VEGF)联合癌胚抗原(Carcino-embryonic antigen,CEA)检测应用于晚期非小细胞肺癌(Non-small-cell carcinoma,NSCLC)伴恶性胸腔积液患者的临床价值.方法应用电化学发光法和酶联免疫反应(Enzyme linked immunosorbent assay,ELISA)分别检测2010年1月-2011年12月湖北省公安县二人民医院收治的186例初治的晚期NSCLC伴恶性胸腔积液患者(研究组)的胸腔积液和血清的CEA和VEGF水平,与186例良性疾病并发胸腔积液患者(对照组)CEA和VEGF水平进行比较.且对研究组中的非鳞癌和鳞癌两个亚组的胸腔积液和血清的CEA和VEGF水平进行进一步比较.结果 研究组胸腔积液和血清中CEA、VEGF水平均高于对照组(P＜0.05),且研究组中非鳞癌亚组的胸腔积液和血清的CEA均显著高于鳞癌亚组,而VEGF则无统计学差异(P＞0.05);研究组血清中的VEGF联合CEA诊断的灵敏度和特异度分别为65.25%和61.99%,胸水中VEGF联合CEA诊断灵敏度和特异度分别为89.00%和79.33%.结论 联合检测胸腔积液和血清CEA、VEGF对晚期NSCLC伴胸腔积液患者具有重要的临床价值.%Objective To explore the clinical value of VEGF and CEA combination test in patients of late stage of non - small cell lung cancer with malignant pleural effusion. Methods To use ECLIA and ELISA method to test levels of CEA and VEGF in 186 cases of first line patients in the late stage of non - small cell lung cancer - study group - with malignant pleural effusion and compare them to that of the patients with benign pleural effusion. And non - squamous and squamous cell carcinoma in the study group in two subgroups of pleural effusion and serum CEA and VEGF levels were further comparison. Results We studied group pleural effusion and serum CEA. VEGF levels were higher than that of the control group( P < 0. 05 ). Non - squamous cell carcinoma subgroup pleural effusion and serum CEA were significantly higher in squamous cell carcinoma subgroup( P < 0.05 ),while there were no significant difference in two subgroups with VEGF( P > 0. 05 ). The sensitivity and specificity of combination test of VEGF and CEA in serum and pleural effusion were 65. 25% and 61. 99% , 89.00% and 79. 33% , respectively. Conclusion Combination test of CEA and VEGF in both pleural effusion and serum is of great clinical application value to patients in the late stage of non - small cell lung cancer with malignant pleural effusion.