肺癌患者血清CEA、CA19-9、CA125、CA153围手术期动态监测的临床意义研究

发布时间：2019-05-17 12:13

【摘要】：背景在世界范围内,肺癌是目前恶性肿瘤中发病率、死亡率均最高的一种恶性病,且随着社会的发展其发病率仍呈上升趋势。肺癌早期诊断率低且确诊时已处于中晚期,五年生存率不足5%。目前肺癌仍以手术治疗为主,结合化疗放疗等综合疗法。肺癌患者的手术疗效是影响患者生存期的主要因素,患者术后是否出现肿瘤的转移和复发尤其重要。目前已发现多种与肺癌相关的血清肿瘤标志物,有文献报道它们在肿瘤的预后分析及评价疗效方面都起到了重要作用。目的动态监测肺癌患者围手术期血清四种肿瘤标志物水平,并探讨其在肺癌患者的整个治疗过程中及预后监测中的临床意义。方法选取2014年5月至2015年5月期间我院呼吸内科收治入院的肺癌患者58例为研究对象,设为肺癌组,其中男性38例,女性20例,年龄42~78岁,平均(53.7±6.8)岁。以上研究对象均经支气管镜活检确诊为肺癌,其中早期(Ⅰ期)肺癌18例,中期(Ⅱ期)肺癌33例,Ⅲ期肺癌7例;按病程将其分为术前、术后1天、术后1周、术后1月及术后3月共五组;其中包括鳞癌29例,腺癌19例,腺样囊性癌2例,腺鳞癌6例,腺泡细胞癌2例;其中分化程度为高分化6例,中分化31例,低分化21例。随机选取同时间段来我院进行体检的健康人50例为对照组,体检结果均正常。其中男性28例,女性22例,年龄40~66岁,平均(51.2±5.6)岁。肺癌组患者与对照组两组的年龄、性别等一般资料均无显著性差异,具有可比性。应用化学发光免疫分析法分别检测肺癌组患者在手术前、术后1天、术后1周、术后1月及术后3月等时间点的空腹血清CEA、CA19-9、CA125、CA153水平,相互进行比较,并与对照组各血清肿瘤标志物结果进行比较。结果1.肺癌组患者在术前的平均空腹血清CEA、CA19-9、CA125、CA153水平均显著高于对照组的四种肿瘤标志物平均空腹血清水平,差异显著具有统计学意义(P0.05);2.肺癌组患者在术后1天、1周、1月及3月的平均空腹血清CEA、CA19-9、CA125、CA153水平均显著低于术前的四种肿瘤标志物平均空腹血清水平,差异显著具有统计学意义(P0.05);3.肺癌组患者在术后1月时的平均空腹血清CEA、CA19-9、CA125、CA153水平均高于其术后3月时的四种肿瘤标志物平均空腹血清水平,但差异均不显著,不具有统计学意义(P0.05)。4.肺癌组患者在术后1月、3月时的空腹血清CEA、CA19-9、CA125、CA153水平与正常组相比差异不具有显著性(P0.05);5.肺癌组患者在不同临床分期的术前平均血清CA19-9水平之间差异均不显著,不具有统计学意义(P0.05);6.肺癌组患者在不同临床分期的术前平均血清CEA、CA125、CA153水平之间的差异显著,均具有统计学意义(P0.05);7.血清CEA、CA125、CA153水平与肿瘤分期呈正相关,肿瘤分期越晚,肺癌患者的血清肿瘤标志物水平越高;8.四种血清肿瘤标志物CEA、CA19-9、CA125、CA153单项检测诊断肺癌的敏感性分别为45.8%、26.5%、40.74%及10.4%,特异性分别为92.5%、90.42%、82.13%及97.8%,但其联合检测的敏感性则为93.06%,特异性为71.4%,效果明显优于单项检测。提示四种血清肿瘤标志物的联合检测可明显提高检测灵敏度。结论对肺癌患者的血清CEA、CA19-9、CA125、CA153水平进行围手术期动态监测有助于临床手术治疗效果的评估。1.动态监测围手术期肺癌患者血清CEA、CA19-9、CA125、CA153的水平变化可以作为临床监测指标评估手术疗效;2.肺癌患者血清CEA、CA19-9、CA125、CA153联合检测优于单项检测,可用于肺癌的辅助诊断和预后的判断。
[Abstract]:Background In the world, lung cancer is a kind of malignant disease with the highest morbidity and mortality in the current malignant tumor, and the incidence of lung cancer is still on the rise with the development of society. The early diagnosis rate of the lung cancer is low and the diagnosis is in the middle and late stage, and the five-year survival rate is less than 5%. At present, lung cancer is still the main surgical treatment, combined with the combination of chemotherapy and radiotherapy. The operation effect of the patients with lung cancer is the main factor that affects the survival of the patients. A variety of serum tumor markers associated with lung cancer have been found, and it has been reported that they play an important role in the analysis and evaluation of the prognosis of the tumor. Objective To monitor the level of serum four tumor markers in the perioperative period of patients with lung cancer, and to discuss the clinical significance of the four types of tumor markers in the whole treatment and prognosis of patients with lung cancer. Methods 58 patients with lung cancer admitted to our hospital from May 2014 to May 2015 were selected as the subjects of lung cancer, including 38 males and 20 females, aged 42 to 78 years, with an average of 53.7 (6.8) years. The above-mentioned subjects were diagnosed with lung cancer by bronchoscopy, including 18 cases of early stage (stage 鈪，

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