鼻咽癌组织中bcl—2及EB病毒潜伏膜蛋白表达与放射诱发细胞？…

目的：探讨鼻咽癌（ＮＰＣ）组织ｂｃｌ－２及ＥＢ病毒潜伏膜蛋白（ＬＭＰ）表达与放射诱发细胞凋亡的关系。方法采用免疫组化Ｓ－Ｐ法及ＴｄＴ酶介导的生物素化ｄＵＴＰ缺口要端标记技术（ＴＵＮＥＬ法）,分别检测３５例ＮＰＣ组中ｂｃｌ－２及ＥＢ病毒ＬＭＰ的表达,以及放疗总量为１０Ｇｙ时ＮＰＣ组织的细胞凋亡率（ＡＲ）。结果ＮＰＣ组织ｂｃｌ－２及ＬＭＰ的表达率分别为７１．４％（２５／３５）、４５．７％（１６／３５）     

小细胞肺癌联合化疗及免疫组化研究

６８例小细胞肺癌（ＳＣＬＣ）用ＣＯＣＥ及ＣＯＭＰ方案化疗，２２例化疗后放疗，其中１４例纤支镜活检标本用神经特异性烯醇化酶（ＮＳＥ），铬粒素Ａ（ＣＧＨ－Ａ），癌胚抗原（ＣＥＡ）和角蛋白（Ｋ）４种抗体进行免疫组化ＡＢＣ法染色。结果总缓解率５８．８％、中位生存期１２．８个月，两方案经卡方检验差异有显著性意义（Ｐ＜０．００５），说明ＣＯＣＥ优于ＣＯＭＰ。化疗加放疗中位生存期１５个月（ＣＯＣＥ１７．３个月，ＣＯＭＰ１２个月），化疗加放疗优于单纯化疗。免疫组化染色结果：ＮＳＥ或／和ＣＧＨ－Ａ阳性者中位生存期２１个月，明显长于ＮＳＥ或／和ＣＧＨ－Ａ阴性者１２个月。ＣＥＡ阳性与阴性者生存时间无明显差异，提示ＳＣＬＣ神经内分泌分化对临床预后的判断有重要的参考价值，而ＣＥＡ对预后的判断作用不明显。     

肺癌生物学特性与灌注化疗疗效和生存关系的初步探讨

本文对１７例Ⅲ期肺癌，测定了癌细胞ＤＮＡ含量，ＤＮＡ指数（ＤＩ），细胞增殖核抗原（ＰＣＮＡ）。１７例肺癌均给支气管动脉灌注化疗。小细胞肺癌（ＳＣＬＣ）和非小细胞肺癌（ＮＳＣＬＣ）分别缩小４８．８±３１．０％，３６．８±１７．１％（Ｘ±ＳＥ）。化疗后７例开胸手术６例切除肿瘤。ＳＣＬＣ和ＮＳＣＬＣ的中位生存期分别为３个月和８．５个月。在ＮＳＣＬＣ中，ＰＣＮＡ与肿瘤缩小范围呈负相关（ｒ＝－０．４７）；ＤＮＡ超四倍体百分比和ＤＩ存活时间呈正相关（（ｒ＝０．５１，ｒ＝０．５６）。ＳＣＬＣ则相关性差。结果表明，ＰＣＮＡ、ＤＡＮ和ＤＩ是ＮＳＣＬＣ判定疗效和预后的有用指标。     

间变性大细胞淋巴瘤EB病毒基因表达产物的检测及其意义

目的：了解间变性大细胞淋巴瘤与埃泼斯坦－巴尔（ＥＢ）病毒的关系。方法：采用原位杂交及免疫组化ＬＳＡＢ法对１２例间变性大细胞淋巴瘤（ＡＬＣＬ）进行ＥＢＶ编码的ＲＮＡ（ＥＢＥＲｓ）及ＥＢＶ潜伏膜蛋白（ＬＭＰＩ）和潜在膜抗原检测。结果：本组１２例ＡＬＣＬ中ＥＢＥＲｓ阳性率为２５％（３／１２）,１２例ＡＬＣＬ ＬＭＰ１检出率为８．３％,ＥＢＮＡ２检出率为０（０／１２）;１２例ＡＬＣＬ免疫表型,８例为Ｔ源性     

EXPRESSION OF c－myc GENE AND BIOSYNTHESIS OF BIOLOGICAL MACROMOLECULES IN ANTISENSE TRANSFECTANT HL_（60）~R－9

ＥＸＰＲＥＳＳＩＯＮＯＦｃ－ｍｙｃＧＥＮＥＡＮＤＢＩＯＳＹＮＴＨＥＳＩＳＯＦＢＩＯＬＯＧＩＣＡＬＭＡＣＲＯＭＯＬＥＣＵＬＥＳＩＮＡＮＴＩＳＥＮＳＥＴＲＡＮＳＦＥＣＴＡＮＴＨＬ_（６０）~Ｒ－９ＬｉＹｉｎｘｉｏｎｇ李尹雄，ＦａｎＭｕｚｈｅｎ范慕贞，Ｚｈａ...     

评价酶联免疫检测血清CYFRA21—1对非小细胞肺癌的诊断价值

目的评价检测ＣＹＦＲＡ２１┐１对非小细胞肺癌的诊断价值。方法用ＥＬＩＳＡ法测定７０例肺癌（ＬＣ）其中４７例非小细胞肺癌（ＮＳＣＬＣ），３例小细胞肺癌（ＳＣＬＣ）和２０例未分型肺癌、６４例肺部良性疾病患者及４０例健康人血清ＣＹＦＲＡ２１┐１浓度。试验的诊断性能用相对操作特征（ＲＯＣ）分析法估测之。结果测得全阈诊断准确率（ＯｖｅｒａｌＤｉａｇ┐ｎｏｓｔｉｃＡｃｃｕｒａｃｉｅｓ）ＬＣ为０．７５、ＮＳＣＬＣ为０．７６，ＳＱＣ为０．８３，ＡＤＥ为０．６７和ＳＣＬＣ为０．３８。在相应于特异性为０．９５的界定值３．４７μｇ／Ｌ处，各型的灵敏度分别为ＳＱＣ０．６２，ＬＣ０．５３，ＮＳＣＬＣ０．５１，ＡＤＥ０．４８和ＳＣＬＣ０．００。结论结果显示ＣＹＦＲＡ２１┐１是ＮＳＣＬＣ较灵敏和特异的一个标志物。未观察到ＴＮＭ各期间该标志物的平均水平有明显的差异；然而异常升高水平的患者的比例随病期的进展而显著增加，提示一系列检测ＣＹＦＲＡ２１┐１水平可能有助于监查ＮＳＣＬＣ患者的疗效。     

非小细胞肺癌神经内分泌分化的免疫组化诊断

目的： 探讨非小细胞肺癌神经内分泌分化的免疫组化诊断。方法： 选择三种神经内分泌共同标记ＣＧＡ、ＳＹＮ、ＮＣＮＭ, 应用免疫组化ＬＳＡＢ 法, 观察它们在ＮＳＣＬＣ 中的表达。结果： 在１６３ 例ＮＳＣＬＣ 中, １８ 例（１１－０４ ％ ） 表达ＣＧＡ,６３ 例（３８－６５ ％ ） 表达ＳＹＮ,４０ 例（２４－５４ ％ ） 表达ＮＣＡＭ 。７７ 例（４７－２４ ％ ） ＮＳＣＬＣ 至少有１ 种ＮＥ 标记表达,其中４０ 例只表达１ 种标记,３０ 例表达２ 种标记,仅７ 例３ 种标记均表达。３ 种标记表达彼此相关（ Ｐ＜０－００５） ,但存在差异（ Ｐ＜ ０－００５） 。与腺癌相比,腺鳞癌、鳞癌、大细胞癌染色阳性率较低。结论：选择３ 种ＮＥ 标记可以检测出ＮＳＣＬＣ 的ＮＥ 分化, 但不能以某一种标记的表达与否作为ＮＳＣＬＣ 的ＮＥ 分化诊断, 应联合检测以至少２ 种标记表达定义为ＮＥ 分化,在不同类型的ＮＳＣＬＣ 中腺癌更易出现ＮＥ 分化。     

非小细胞肺癌中P—gp,p53,bcl—2蛋白表达及其相关性研究

目的 研究非小细胞肺癌（ＮＳＣＬＣ）中ｐ５３、ｂｃｌ－２蛋白以及耐多药基因ＭＤＲ１产物Ｐ－糖蛋白（Ｐ－ｇｐ）的表达及相互关系,探讨它们在ＮＳＣＬＣ发展、预后及耐药中的作用。方法 采用免疫组化Ｓ－Ｐ法,对６０例ＮＳＣＬＣ及其癌旁正常肺组织中ｐ５３、ｂｃｌ－２蛋白和Ｐ－ｇｐ进行检测。结果 ｐ５３、ｂｃｌ－２蛋白及Ｐｇｐ在ＮＳＣＬＣ中表达明显高于癌旁正常组织（Ｐ〈０．０１）。两者都与患者预后显著负相关（     

肝癌单克隆抗体与氨甲喋呤交联物的制备及细胞毒的研究

在肝癌单克隆抗体Ｈｅｐａｍａ－１－人血清白蛋白－ＭＴＸ结合物的制备中，首先ＭＴＸ在二环己基碳二亚胺（Ｄｉｃｙｃｌｏｈｅｘｙｌｃａｒｂｏｄｉｍｉｄｅ，ＤＣＣ）作用下，与Ｎ－羟基琥珀酰亚胺（Ｎ－Ｈｙｄｒｏｘｙｓｕｃｃｉｎｉｍｉｄｅ，ＮＨＳ）反应，得到ＭＴＸ活性酯，中间载体ＨＳＡ与ＳＰＤＰ作用引入巯基，再与ＭＴＸ活性酯反应得到ＨＳ－ＨＳＡ－ＭＴＸ。然后与碘乙酰化单克隆抗体Ｈｅｐａｍａ－Ｉ反应，获得硫醚键连接的交联物。交联物中Ｈｅｐａｍａ－Ｉ：ＨＳＡ：ＭＴＸ克分子比为１１．６３０，对靶细胞ＢＥＬ－７４０５及对照细胞ＨｅＬａ的杀伤效率，以交联物按ＭＴＸ的克分子浓度计算，ＩＣ５０（５０％抑止率）分别为２．５×１０－８ｍｏｌ／Ｌ和６．４×１０－７ｍｏｌ／Ｌ。单独ＭＴＸ对上述二种细胞株不显示选择性杀伤，ＩＣ５０均为７．１×１０－８ｍｏｌ／Ｌ。     

ｄｄＰＣＲ与 ＡＲＭＳ-ＰＣＲ检 测 ＮＳＣＬＣ患者ＥＧＦＲ基因Ｔ７９０Ｍ突变的比较研究

目的：通过对比微滴式数字 ＰＣＲ（ｄｒｏｐｌｅｔｄｉｇｉｔａｌＰＣＲ,ｄｄＰＣＲ）和突变扩增阻滞系统 ＰＣＲ（ａｍｐｌｉｆｉｃａｔｉｏｎｒｅｆｒａｃ ｔｏｒｙｍｕｔａｔｉｏｎｓｙｓｔｅｍＰＣＲ,ＡＲＭＳ ＰＣＲ）检测非小细胞肺癌（ｎｏｎ ｓｍａｌｌｃｅｌｌｌｕｎｇｃａｎｃｅｒ,ＮＳＣＬＣ）表皮生长因子受体（ｅｐｉ ｄｅｒｍａｌｇｒｏｗｔｈｆａｃｔｏｒｒｅｃｅｐｔｏｒ,ＥＧＦＲ）基因 Ｔ７９０Ｍ突变的检测效能,综合分析两种检测方法的优势及适用范围。方法： 回顾性收集 １１５例 ＮＳＣＬＣ患者的标本,同时使用 ｄｄＰＣＲ和 ＡＲＭＳ ＰＣＲ两种方法检测 ＥＧＦＲ基因 Ｔ７９０Ｍ突变状态, 比较两种方法的检测结果,并分析不同样本类型对 ｄｄＰＣＲ检测结果的影响。结果：ｄｄＰＣＲ检测 Ｔ７９０Ｍ阳性率为 ６５．２％,ＡＲＭＳ ＰＣＲ阳性率为 ２７．８％,ｄｄＰＣＲ检测敏感性显著高于 ＡＲＭＳ ＰＣＲ（Ｐ＜０．０５）,两种方法检测一致率为 ６２．６％。ｄｄＰＣＲ＋ＡＲＭＳ－样本的 Ｔ７９０Ｍ平均阳性微滴数和平均突变丰度（１１,０．３５％）均显著低于 ｄｄＰＣＲ＋ＡＲＭＳ ＋样本（６３２．３,１７．７％）。ｄｄＰＣＲ检测基因组 ＤＮＡ和外周血游离 ＤＮＡ阳性率分别为 ５５．９％和 ７８．７％,不同样本类 型 Ｔ７９０Ｍ突变阳性微滴数和突变丰度无显著差别。结论：ｄｄＰＣＲ和 ＡＲＭＳ ＰＣＲ均可用于 ＮＳＣＬＣ患者 ＥＧＦＲ基因 Ｔ７９０Ｍ突变检测,二者具有良好的一致性,ｄｄＰＣＲ具有更高的灵敏性,在检测突变丰度较低的样本方面具有优势。     

Quantitative Distribution of Cluster 1 Small Cell Lung Cancer Antigen in Cancerous and Non-cancerous Tissues, Cultured Cells and Sera

Three monoclonal antibodies (mAbs), NCC-LU-243, -244 and -246, detected three different epitopes on a 145-kDa cell membrane antigen, which had been designated as the cluster 1 antigen at the First International Workshop on Small Cell Lung Cancer (SCLC) Antigens. The distribution of the antigen in various tissues, cultured cells and sera was examined by immunohistochemistry and sandwich radioimmunoassay using these mAbs. The antigen is a normal differentiation antigen and is present in nenronal, nenroendocrine and cardiac muscle cells. The level of the antigen was highest in central nervous tissues, while it was undetectable in the liver, kidney and peripheral lung. Among tumor tissues, the antigen was detected only in SCLC, carcinoid tumor and neuroblastoma, indicating its usefulness as a marker for discriminating SCLC from non-SCLC. The level of the antigen varied among SCLC tissues and tended to be lower in variant-type cultured SCLC cells. Although an increase in the antigen level was observed in sera of some patients with advanced SCLC, the antigen did not possess any additional value over neuron-specific enolase as a serum tumor marker for monitoring SCLC patients.     

Quantitative distribution of cluster 1 small cell lung cancer antigen in cancerous and non-cancerous tissues, cultured cells and sera

Three monoclonal antibodies (mAbs), NCC-LU-243, -244 and -246, detected three different epitopes on a 145-kDa cell membrane antigen, which had been designated as the cluster 1 antigen at the First International Workshop on Small Cell Lung Cancer (SCLC) Antigens. The distribution of the antigen in various tissues, cultured cells and sera was examined by immunohistochemistry and sandwich radioimmunoassay using these mAbs. The antigen is a normal differentiation antigen and is present in neuronal, neuroendocrine and cardiac muscle cells. The level of the antigen was highest in central nervous tissues, while it was undetectable in the liver, kidney and peripheral lung. Among tumor tissues, the antigen was detected only in SCLC, carcinoid tumor and neuroblastoma, indicating its usefulness as a marker for discriminating SCLC from non-SCLC. The level of the antigen varied among SCLC tissues and tended to be lower in variant-type cultured SCLC cells. Although an increase in the antigen level was observed in sera of some patients with advanced SCLC, the antigen did not possess any additional value over neuron-specific enolase as a serum tumor marker for monitoring SCLC patients.     

Pro-gastrin-releasing peptide (31-98) as a tumour marker of small-cell lung cancer: comparative evaluation with neuron-specific enolase.

We attempted to clarify whether serum levels of a carboxy-terminal fragment of ProGRP, ProGRP(31-98), could serve as a more accurate tumour marker in patients with SCLC than neuron-specific enolase (NSE). ProGRP(31-98) and NSE were measured retrospectively in 101 newly diagnosed untreated patients with SCLC, 111 with non-small-cell lung cancer (NSCLC) and 114 patients with non-malignant lung diseases. ProGRP(31-98) and NSE levels were determined using a sandwich enzyme-linked immunosorbent assay. Sensitivity in SCLC patients was 72.3% for ProGRP(31-98) and 62.4% for NSE. Comparing the area under curve (AUC) of ''receiver operator characteristics'' of ProGRP(31-98) with that of NSE, ProGRP(31-98) was the more powerful marker in the diagnosis of SCLC (P = 0.0001). Serum levels of ProGRP(31-98) were higher in the 40 patients with extensive disease than in the 61 patients with limited disease (P = 0.0082). ProGRP(31-98) was significantly higher in patients with pure small-cell carcinoma than in patients with mixed small-cell/large-cell carcinoma (P = 0.02). In serial measurement in 16 patients responding to treatment, a high degree of correlation was noted between the decrease in serum ProGRP(31-98) levels and clinical response during the second week after treatment (P = 0.0045). These results indicate that the determination of serum ProGRP(31-98) levels plays an important role in the diagnosis and treatment of SCLC patients.     

ANALYSIS ON EPITOPES OF IGM WITH MONOCLONAL ANTI-ISOTYPIC AND ANTI-IDIOTYPIC ANTIBODIES AGAINST IgM FROM B-CLL

A double antibodies additivity ELISA test was employed to identify the epltopes which can be recognized by monoclonal antibodies (McAbs) against IgM from B chronic lymphocyte leukemia (B-CLL). The computer grouping programme analysis showed that 4 and- isotypic MaAbs could be divided into two groups and 10 anti- idiotype McAbs could be divided into four groups. The result was consistent with that of the indirect sandwich ELISA and inhibition ELISA test. It suggested that there were at least 6 distinct IgM epitopes which can react specifically with 14 McAbs. Our study indicated that the combination of the additivity ELISA test and the computer grouping programme analysis is of help in studying the relationship of the structure and function of antigen.     

Prognostic and predictive value of vascular endothelial growth factor and its soluble receptors, VEGFR-1 and VEGFR-2 levels in the sera of small cell lung cancer patients

OBJECTIVES: Small cell lung cancer (SCLC) has a rapid growth rate and is characterized by early metastases. Tumor growth is dependent on angiogenesis. Vascular endothelial growth factor (VEGF) is an important regulator of angiogenesis. Whether surveillance of pre- and post-treatment serum VEGF and especially its receptors VEGF-1 and VEGF-2 levels in SCLC patients have impact on clinical outcome is unknown. METHODS: From February 2001 to January 2003, 39 consecutive patients with histological proven SCLC were enrolled into the study. Pre-treatment (n: 39) and post-treatment (n: 25) samples of the same patients were collected at the time of their response evaluation. The levels of VEGF and its receptors VEGFR-1 and VEGFR-2 were measured in the serum by quantitative sandwich enzyme immunoassay technique. RESULTS: The median pre-treatment serum VEGF, VEGFR-1, and VEGFR-2 levels which were significantly higher than the normal controls were 1,200 pg/ml (range, 1,414.3 +/- 956.2 pg/ml), 85 pg/ml (range, 97.8 +/- 70.7 pg/ml), and 11,550 pg/ml (range, 14,481 +/- 6,267 pg/ml), respectively. We detected a poor but positive correlation between VEGF and VEGFR-2 (r: 0.46, p: 0.003). Pre-treatment low serum VEGF (<728.5 pg/ml) value (p: 0.02) and good response to treatment (p: 0.008) were found as good prognostic factors by multivariate analysis. CONCLUSIONS: Low serum VEGF concentration is a significant and independent prognostic factor in SCLC patients. Surveillance of VEGF and its receptors to predict chemotherapy response is not useful. Whether the levels of serum VEGF and its receptors VEGFR-1 and VEGFR-2 have value in detecting treatment modalities of SCLC need further studies.     

抗人小扁豆凝集素结合型甲胎蛋白异质体单克隆抗体...

In this paper, we report on the preparation and application of anti-human heterogeneous AFP-R-LCA monoclonal antibodies (VG5, VD12, VB5, VA8, VD1). These McAbs were more sensitive and specific for AFP-R-LCA than the anti-AFP polyclonal antibody routinely used. The twin site (a and b) sandwich ELISA method so established was used to test the serum samples of 69 PHC patients, 67 patients with benign liver diseases, 30 pregnant women and 30 normal controls. The results showed that this twin site sandwich ELISA method gave a false positive reaction in only 2.1% and was 81.2% (56/69) positive reaction, giving a positive reaction to 5-100 ng/ml. It was positive in PHC patients with AFP levels less than 400 ng/ml. This method, being simple, accurate and reliable, is valuable in the differential diagnosis of PHC from benign liver diseases.     

Standard- and high-dose etoposide, ifosfamide, carboplatin, and epirubicin in 100 patients with small-cell lung cancer: A mature follow-up report

Background: We conducted a phase I–II trial to assess the feasibility and activity of a combination chemotherapy regimen with etoposide, ifosfamide, cisplatin or carboplatin, and epirubicin in limited-disease (LD, stages I–IIIB) and extensive-stage (ED, stage IV) small-cell lung cancer (SCLC).Patients and methods: Standard-dose chemotherapy (SDC) consisting of etoposide (500 mg/m2), ifosfamide (4000 mg/m2), cisplatin (50 mg/m2) and epirubicin (50 mg/m2) (VIP-E), followed by granulocyte colony-stimulating factor (G-CSF), was given to 100 patients with SCLC. Thirty patients with qualifying responses to VIP-E proceeded to high-dose chemotherapy (HDC) with autologous peripheral blood stem-cell transplantation (PBSCT) after etoposide (1,500 mg/m2), ifosfamide (12,000 mg/m2), carboplatin (750 mg/m2) and epirubicin (150 mg/m2) (VIC-E) conditioning.Results of standard-dose VIP-E: Ninety-seven patients were evaluable for response. The objective response rate was 81% in LD SCLC (33% CR, 48% PR; excluding patients in surgical CR) and 77% in ED SCLC (18% CR, 58% PR). The treatment-related mortality (TRM) of SDC was 2%. Two additional patients in CR from their SCLC developed secondary non-small-cell lung cancers (NSCLC), and both were cured by surgery. The median survival was 19 months in LD SCLC and 6 months in ED SCLC. The five-year survivals were 36% in LD and 0% in ED SCLC.Results of high-dose VIC-E: HDC was feasible in 16% of ED-, and 58% of LD-patients. All HDC patients (n = 30) improved or maintained prior responses. Four patients died of early treatment-related complications (TRM 13%). Two additional patients in CR from their SCLC developed secondary malignancies (esophageal cancer, secondary chronic myelogenous leukemia). The median survivals were 26 months in LD SCLC, and 8 months in ED SCLC. The five-year survival was 50% in LD and 0% in ED SCLC.Conclusions: Despite high response rates, survival after VIP-E SDC and VIC-E HDC in patients with ED SCLC is not superior to that achieved with less toxic traditional regimens. The high five-year survival rates achieved with these protocols in LD SCLC probably reflect both patient selection (high proportion of patients with prior surgical resection) and the high activity of our chemotherapy regimen in combination with radiotherapy. A study comparing protocols using simultaneous radiation therapy and chemotherapy, and other dose-escalated forms of SDC with HDC is needed to further define the role of this treatment modality in SCLC. Given the high rate of secondary malignancies observed in patients in CR >2 years in our study, close follow-up and early treatment of these neoplasms may contribute to maintaining overall survival in patients with SCLC.     

The interaction of Kaposi's sarcoma with monoclonal antibodies to human sarcoma and connective tissue differentiation antigens

Four monoclonal antibodies (McAbs) previously generated against human soft tissue sarcomas and reacting with connective tissue differentiation antigens were evaluated for their interaction with tissues obtained from patients with classic Kaposi's sarcoma. Biopsy was performed on active neoplastic lesions from the skin of 26 patients, frozen sections were prepared, and the binding of the McAbs was tested using the indirect immunofluorescence assay. Clinically uninvolved skin from the same patients as well as skin and muscle from eight non-cancer patients were treated similarly and served as controls. McAbs IXG11, 23H7, IIIE5, and 15G5 interacted strongly with the Kaposi's sarcoma lesions and weakly with the uninvolved skin in 22 of 26 (84%), 23 of 26 (88%), 12 of 14 (85%), and 1 of 6 (16%) of the patients, respectively. IXG11, 23H7, and IIIE5 interacted weakly with the skin of seven of eight non-cancer patients. McAb 15G5 was found to bind strongly to tumor lesions, to the respective uninvolved skin in four of five Kaposi's sarcoma patients, and also to skin and connective tissues of muscle from non-cancer patients. The mode of interaction was morphologically different for each McAb. It is suggested that McAbs IXG11, 23H7 and IIIE5 identify markers whose expression is markedly increased in Kaposi's sarcoma lesions as compared with uninvolved skin of the same patients. These markers may serve as immunologic probes for the investigation of this neoplastic process.     

小细胞肺癌患者五种肿瘤标志物检测的临床意义

目的:探讨小细胞肺癌（SCLC）患者血清癌胚抗原（CEA）、鳞状细胞癌抗原（SCCA）、神经元特异性烯醇化酶（NSE）、细胞角质蛋白19 片段抗原21-1（CYFRA21-1）、胸苷激酶1（TK1）检测的临床价值。方法:选取2018年1月至2020年6月收治的SCLC患者64例（SCLC组）、NSCLC患者60例（NSCLC组）以及同期在我院体检的健康人50例（对照组）,检测并比较上述各组以及SCLC不同分期、不同化疗时间点、不同疗效患者五种肿瘤标志物水平;采用ROC曲线分析五种肿瘤标志物对SCLC的诊断效能;采用Logistic回归分析SCLC发病的独立危险因素。结果:SCLC组CEA、NSE、CYFRA21-1、TK1指标高于对照组（P＜0.05）;SCLC组NSE高于NSCLC组,其他四种指标均低于NSCLC组（P＜0.05）;局限期SCLC患者CEA、NSE、CYFRA21-1、TK1低于广泛期患者（P＜0.05）;SCLC患者化疗2个周期、4个周期后NSE、CYFRA21-1、TK1低于治疗前（P＜0.05）;化疗4个周期TK1低于化疗2个周期（P＜0.05）;化疗后CR+PR患者NSE、CYFRA21-1、TK1低于SD+PD患者（P＜0.05）;ROC曲线分析显示,CEA（AUC=0.657）、NSE（AUC=0.805）、CYFRA21-1（AUC=0.675）、TK1（AUC=0.868）诊断SCLC的AUC值差异有统计学意义（P＜0.05）;Logistic回归分析显示,NSE、TK1是SCLC发病的独立危险因素（P＜0.05）。结论:NSE、TK1是SCLC发病的独立危险因素,对SCLC的诊断效能较高,可作为SCLC诊断的参考指标。