晚期肺鳞癌患者肿瘤标志物测定的临床分析

背景与目的肺鳞癌由于发病隐匿，早期无明显症状，往往到晚期才得以诊断。本研究旨在描述性分析晚期肺鳞癌患者的基本特征和多种肿瘤标志物检测水平及阳性率情况，评价其临床价值。方法以2011年1月-2015年12月期间于中国医学科学院肿瘤医院诊治的晚期肺鳞癌患者作为研究对象，通过病历回顾收集相关资料，描述性分析晚期肺鳞癌患者基本特征、肿瘤标志物检测水平和阳性率。结果260例患者的平均年龄为（59.4±9.2）岁，男性223例（85.8%），女性37例（14.2%）。203例（78.1%）有吸烟史，8例（3.1%）有癌症家族史。细胞角质蛋白19的片断（cytokerantin 19 fragment, CYFRA21-1）的检测阳性率最高（71.2%）。不同肿瘤原发灶（tumor, T）分期和淋巴结受累（node, N）分期患者五种指标检测水平无统计学差异（P>0.05），仅鳞状细胞癌相关抗原（squamous cell carcinoma antigen, SCC）在不同T分期的检测阳性率有统计学差异（P=0.035）。二联阳性率最高的为CYFAR21-1+蛋白质类的癌胚抗原（carcinogen-embryonic antigen, CEA），阳性率为82.7%，三联阳性率最高的为癌抗原12-5（cancer antigen 125, CA125）+CYFAR21-1+CEA，阳性率为84.6%，四联阳性率最高为CA125+CYFAR21-1+CEA+酶类标志物神经烯醇化酶（neuron speciifc enolase, NSE），阳性率为85.0%，五联的阳性率为86.2%。结论 CYFAR21-1的检测阳性率最高，单项肿瘤标志物的检测灵敏度较低，联合检测可提高对肺鳞癌的诊断灵敏度，首选CA125、CYFAR21-1和CEA联合。

Clinical Signiifcance of Tumor Marker Detection in Patients with Advanced Squamous Cell Carcimoma of the Lung

Background and objective Due to it's concealment and no obvious symptoms, lung squamous carcimoma otfen has advanced disease when diagnosed. hTe aims of this study were to describe the characteristics of the disease, to evaluate the clinical importance of detection of multiple tumor markers in patients with squamous cell carci-noma of the lung.Methods hTe characteristics of all patients with advanced squamous cell lung cancer treated in Beijing Cancer Hospital of Chinese Academy of Medical Sciences during Jan. 2011 to Dec. 2015 were identiifed by cases review-ing and data extracting. hTe characteristics, detection levels and sensitivity of multiple tumor makers among patients were described.Results hTe 260 patients were treated with mean age of (59.4±9.2) years, 85.8% (n=223) of them were male, 14.2% (n=37) of them were female. 78.1% (n=203) of all were smokers and 3.1% (n=8) of patients had family history of tumor. hTe positive rate of cytokerantin 19 fragment (CYFAR21-1) was 71.2%, which was the highest among ifve tumor markers. hTe ifve tumor markers median level had no statistical signiifcance between different tumor (T) stages and node (N) stages (allP>0.05), only the positive rate of SCC had statistical signiifcance between different T stages (P=0.035). hTe combination measurement of CYFRA21-1+carcinogen-embryonic antigen (CEA), CYFRA21-1+CEA+cancer antigen (CA125), CA125+CYFAR21-1+CEA+neuron speciifc enolase (NSE), and CA125+CYFAR21-1+NSE+CEA+squamous cell carcinoma antigen (SCC) were better and had higher clinical values, the positive rates were 82.7%, 84.6%, 85.0% and 86.2%, respectively.Conclusion hTe positive rate of CYFAR21-1 was the highest and the sensitivity of single test of ifve tumor markers was low, the combination of multiple tumor markers increased the sensitivity of diagnosis of SQCLC, the combination of CA125, CYFAR21-1 and CEA was the best choice.