摘要
背景与目的血清肿瘤标志物的检测对肺癌的早期诊断有着重要的意义。本研究旨在通过回顾性统计分析,总结肺癌血清肿瘤标志物检测的临床意义及特点。方法应用meta分析方法对有关肺癌血清肿瘤标志物的文献进行综合定量评价。入选712篇文献,病例组、对照组病例均>20例,共统计肿瘤血清52832例,对照血清32037例。结果 13项肿瘤标志物对肺癌具有诊断意义,CEA、CA125、CYFRA21-1、TPA、SCCAg、DKK1、NSE和ProGRP的敏感度分别为47.50%、50.11%、57.00%、50.93%、49.00%、69.50%、39.73%和51.48%,特异度分别为92.34%、80.19%、90.16%、88.41%、91.07%、92.20%、89.11%和94.89%。多指标联合分析显示,NSE+ProGRP对小细胞肺癌的诊断敏感度和特异度分别为88.90%和72.82%。SCCAg+CYFRA21-1联合肿瘤生长因子TSGF对鳞癌诊断的敏感度和特异度分别为95.30%和74.20%;CA153+Ferrtin+CEA对肺癌诊断的敏感度和特异度分别为91.90%和44.00%。结论肿瘤血清标志物对早期肺癌的诊断有临床意义,单项指标检测敏感度及特异度较低,多指标联合检测能提高诊断的敏感度和特异度。
Background and objective The detection of serum tumor markers is of great value for early diagnosis of lung cancer. The aim of this study is to summarize the clinic significance characteristics of serum markers contributing to the detection of lung cancer. Methods References about serum markers of lung cancer were estimated using meta-analysis method. 712 references which included more than 20 cases,20 controls,the serum markers of 52 832 patients with malignancies and 32 037 patients as controls were evaluated. Results Overall the detection of 13 markers play a significant part in lung cancer diagnosis. The sensitivity of CEA,CA125,CYFRA21-1,TPA,SCCAg,DKK1,NSE,ProGRP in the patients’ serum with lung cancer were 47.50%,50.11%,57.00%,50.93%,49.00%,69.50%,39.73%,51.48% and the specificity were 92.34%,80.19%,90.16%,88.41%,91.07%,92.20%,89.11%,94.89%. In the combined analysis of tumor markers： the sensitivity,specificity of NSE＋ProGRP were 88.90% and 72.82% in diagnosis of small cell lung cancer,respectively. In diagnosis of squamous corcinoma,the sensitivity and specificity of TSGF＋SCCAg＋CYFRA21-1 were 95.30% and 74.20%. The the sensitivity and specificity of CA153＋Ferrtin＋CEA were 91.90% and 44.00% in diagnosis of lung cancer. Conclusion Although the assay of tumor markers in serum is useful for diagnosis of early lung cancer,the sensitivity and specificity are low. Combined detection of these tumor markers could increase sensitivity and specificity.
出处
《中国肺癌杂志》
CAS
2010年第12期1136-1140,共5页
Chinese Journal of Lung Cancer
