摘要
目的探讨肿瘤标志物诊断肺癌的合理组合，以避免过度医疗。方法选择106例肺癌病人和30例肺部良性疾病病人，以电化学发光免疫法测定其血清中6种常用肿瘤标志物——可溶性细胞角蛋白19片段（CYFRA21—1）、癌胚抗原（CEA）、神经元特异性烯醇酶（NSE）及糖类抗原153、125、199（CA153、CA125、CA199）的含量为主方法，以经济学领域中卫生服务需求理论分析为副方法，共同为避免过度医疗求证合理数据。结果6种肿瘤标志物在肺癌病人中的含量均明显高于肺部良性疾病组（Z＝1．979～5．988，P〈0．05、0．01）。NSE在小细胞肺癌、CEA在腺癌、CYFRA21—1在鳞癌中敏感度最高，分别为79．4％、71．8％、69．7％。结论以NSE、CEA、CY—FRA21—1作为肺癌肿瘤标志物联检的核心组合，再使用经济学的边际效用递减规律来推测联检所需项数的合理范围，可避免过度医疗。
Objective To study reasonable combination of tumor markers in the diagnosis of lung cancer to avoid excessive medical treatment. Methods Six commonly used tumor markers （CYFRA 21-1,CEA,NSE, CA153, CA125, CA199） in 106 patients with lung cancers and 30 patients with benign pulmonary diseases were detected by ECLIA. An analysis of health service demand theory in economics domain as a secondary method. Results Serum levels of the six tumor markers in the cancer patients were significantly higher than that in patients with benign pulmonary diseases （Z= 1. 979- 5. 988;P〈0.05,0.01）. The highest sensitivity of NSE was found in small cell lung cancer （79.4%）, that of CEA in adenocarcinoma （71.8%） and CYFRA21- 1 in squamous cancer （69.7%）. Conclusion Serum levels of NSE, CEA and CYFRA21-1 can serve as tumor markers core combination for diagnosis of lung cancers. ＂Marginal utility decrease progressively rule＂ in economics domain can be used to presume the number of associated examination items so as to avoid excessive medical treatment.
出处
《青岛大学医学院学报》
CAS
2008年第2期133-135,138,共4页
Acta Academiae Medicinae Qingdao Universitatis
关键词
肺肿瘤
肿瘤标记
生物学
过度医疗
Lung neoplasms
Tumor markers, biological
Excessive medical treatment
