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中华诊断学电子杂志 ›› 2018, Vol. 06 ›› Issue (04) : 247 -251. doi: 10.3877/cma.j.issn.2095-655X.2018.04.007

所属专题： 文献；

临床研究

血清细胞角蛋白19片段抗原、糖类抗原125和50水平在肺癌中的诊断价值
王文洋1, 李毅1, 王超群1, 王铮1, 冯强1,†()   
  1. 1. 271000　泰安市中心医院检验科
  • 收稿日期:2018-05-17 出版日期:2018-11-26
  • 通信作者: 冯强
  • 基金资助:
    山东省医药卫生科技发展计划(2016WS0600)

Diagnostic value of serum cytokeratin 19 fragment antigen, carbohydrate antigen 125 and 50 levels in lung cancer

Wenyang Wang1, Yi Li1, Chaoqun Wang1, Zheng Wang1, Qiang Feng1,†()   

  1. 1. Department of Laboratory, Tai′an Central Hospital, Tai′an 271000, China
  • Received:2018-05-17 Published:2018-11-26
  • Corresponding author: Qiang Feng
  • About author:
    Corresponding author: Feng Qiang, Email:
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引用本文：

王文洋, 李毅, 王超群, 王铮, 冯强. 血清细胞角蛋白19片段抗原、糖类抗原125和50水平在肺癌中的诊断价值[J/OL]. 中华诊断学电子杂志, 2018, 06(04): 247-251.

Wenyang Wang, Yi Li, Chaoqun Wang, Zheng Wang, Qiang Feng. Diagnostic value of serum cytokeratin 19 fragment antigen, carbohydrate antigen 125 and 50 levels in lung cancer[J/OL]. Chinese Journal of Diagnostics(Electronic Edition), 2018, 06(04): 247-251.

目的

探讨血清细胞角蛋白19片段抗原(CYFRA21-1)、糖类抗原125(CA125)和糖类抗原50(CA50)水平在肺癌诊断中的应用价值。

方法

回顾性分析泰安市中心医院肿瘤科2012年1月至2013年12月收治的肺癌患者233例(研究组)，其中非小细胞肺癌181例(腺癌129例，鳞癌52例)，小细胞癌47例，其他类型5例；同期30例肺良性病变患者作为对照组。电化学发光法检测患者血清CYFRA21-1、CA125和CA50水平，比较3种标志物在肺癌不同病理类型患者中的水平以及联合检测对肺腺癌诊断和TNM分期的诊断价值，Kaplan-Meier生存曲线分析血清中3项标志物单项阳性和多项阳性的肺腺癌患者的生存时间。

结果

腺癌组血清CA125和CA50[(125.06±42.98)U/mL，(17.43±8.51)U/mL]水平明显高于鳞癌组[(65.06±39.03)U/mL，(11.28±9.01)U/mL]和小细胞癌组[(70.32±49.88)U/mL，(7.43±6.07)U/mL](腺癌与鳞癌比较，CA125：q＝18.21，P＝0.01，CA50：q＝3.98，P＝0.05；腺癌与小细胞癌比较，CA125：q＝16.64，P＝0.03，CA50：q＝5.98，P＝0.03)，腺癌组血清CYFRA21-1水平[(12.28±7.08)μg/L]高于小细胞癌组[(7.07±6.23)μg/L](q＝5.12，P＝0.03)；腺癌TNM分期中，Ⅰ期患者的CYFRA21-1、CA125水平[(9.12±8.09)μg/L，(35.23±18.77)U/mL]明显低于Ⅳ期患者[(48.40±13.61)μg/L，(179.36±33.19)U/mL](CYFRA21-1：q＝8.28，P＝0.02；CA125：q＝31.21，P＝0.00)；3项标志物联合检测敏感度为89.97%，特异度为85.09%；3项标志物单项阳性患者的生存时间长于多项阳性的肺腺癌患者(χ2＝2.91，P<0.01)。

结论

血清CYFRA21-1、CA125和CA50水平检测在肺癌诊断、分期和预后中具有重要作用。

关键词: 细胞角蛋白19片段抗原, CA-125抗原, CA-50抗原, 肺肿瘤, 生存期
Objective

To explore the value of serum cytokeratin 19 fragment antigen (CYFRA21-1), carbohydrate antigen 125 (CA125) and carbohydrate antigen 50 (CA50) levels in the diagnosis of lung cancer.

Methods

A retrospective analysis of 233 cases of lung cancer admitted to the Department of Oncology from January 2012 to December 2013 in Tai′an Central Hospital, including 181 cases of non small cell lung cancer (129 cases of adenocarcinoma, 52 cases of squamous cell carcinoma), 47 cases of small cell carcinoma, 5 cases of other types and 30 cases of benign lung lesions in the same period as control group. The serum levels of CYFRA21-1, CA125 and CA50 were detected by electrochemiluminescence. The levels of the 3 markers in patients with different pathological types of lung cancer and the diagnostic value of combined detection on the diagnosis of lung adenocarcinoma and TNM staging were compared, and the Kaplan-Meier survival curve was used to analyze the relationship between the patient′s life cycle of the single positive and multiple positive lung adenocarcinoma of the 3 markers in the serum.

Results

The levels of CA125 and CA50 were significantly higher in the adenocarcinoma group [(125.06±42.98)U/mL, (17.43±8.51)U/mL] than those in the squamous cell carcinoma group [(65.06±39.03)U/mL, (11.28±9.01)U/mL], and the small cell carcinoma group [(70.32±49.88)U/mL, (7.43±6.07)U/mL] (adenocarcinoma compared with squamous cell carcinoma, CA125: q=18.21, P=0.01, CA50: q=3.98, P=0.05; adenocarcinoma compared with small cell carcinoma, CA125: q=16.64, P=0.03, CA50: q=5.98, P=0.03). The levels of CYFRA21-1 [(12.28±7.08)μg/L] in adenocarcinoma was higher than that of small cell carcinoma group [(7.07±6.23)μg/L] (q=5.12, P=0.03). In the TNM stage of cancer, the levels of CYFRA21-1 and CA125 in stage Ⅰ [(9.12±8.09)μg/L, (35.23±18.77)U/mL] were significantly lower than that of stage Ⅳ patients [(48.40±13.61)μg/L, (179.36±33.19)U/mL](CYFRA21-1: q=8.28, P=0.02; CA125: q=31.21, P=0.00); the sensitivity of the 3 markers combined detection was 89.97%, while the specificity was 85.09%, and the survival period of the 3 marker single positive patients was longer than that of multiple positive lung adenocarcinoma (χ2=2.91, P<0.01).

Conclusion

Serum CYFRA21-1, CA125 and CA50 play important roles in the diagnosis, staging and prognosis of lung cancer.

Key words: Cytokeratin 19 fragment antigen, CA-125 antigen, CA-50 antigen, Lung neoplasms, Survival time
表1 不同病理类型肺癌患者CYFRA21-1CA125和CA50水平比较(±s)
肺癌分组 例数 CYFRA21-1(μg/L) CA125(U/mL) CA50(U/mL)
鳞癌 52 10.75±6.29 65.06±39.03 11.28±9.01
腺癌 129 12.28±7.08 125.06±42.98 17.43±8.51
小细胞癌 47 7.07±6.23 70.32±49.88 7.43±6.07
对照组 30 1.98±1.02 19.07±9.77 5.33±2.45
F值 ? 3.92 6.16 3.89
P值 ? 0.03 0.01 0.05
表2 肺腺癌不同TNM分期患者血清CYFRA21-1、CA125和CA50水平比较(±s)
腺癌TNM分期 例数 CYFRA21-1(μg/L) CA125(U/mL) CA50(U/mL)
Ⅰ期 18 9.12±8.09 35.23±18.77 10.03±7.28
Ⅱ期 30 11.69±9.33 79.95±31.98 13.09±8.17
Ⅲ期 32 22.02±10.09 159.23±31.31 12.24±10.17
Ⅳ期 49 48.40±13.61 179.36±33.19 16.17±12.73
F值 ? 6.13 17.23 1.19
P值 ? 0.04 0.00 0.24
表3 3项标志物单项检测和联合检测对肺癌的诊断价值(%)
肿瘤标志物 敏感度 特异度
CYFRA21-1 59.77 91.23
CA125 41.98 70.98
CA50 51.09 68.89
CYFRA21-1＋CA125 62.71 88.11
CYFRA21-1＋CA50 77.17 81.12
CA125＋CA50 73.98 83.42
CYFRA21-1＋CA125＋CA50 89.97 85.09
图1 血清CYFRA21-1、CA125和CA50水平检测单项阳性和多项阳性的肺腺癌患者的生存函数曲线
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