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1、·26·ChinJTubercRespirDis,January1998,Vol21,No.1·论著·血清细胞角蛋白19片段检测对肺癌的临床意义李睿李蓉王亚文【摘要】目的确定我国肺癌患者血清细胞角蛋白19片段(CYFRA21-1)浓度阈值,探讨其临床应用价值。方法应用单克隆抗体(Ks19.1和BM19.21)检测72例初次确诊肺癌患者和50例肺良性疾病患者以及33例治疗后肺癌患者血清CYFRA21-1水平。采用ROC曲线确定CYFRA21-1浓度阈值。结果(1)肺癌患者血清CYFRA21-1水平显著高于肺良性疾病患者(P<0.001),鳞癌显著高于其它病理类型,且其浓度随临床分期升
2、高而升高。(2)当阈值定为5.5Lg/L时,CYFRA21-1检测肺癌的敏感性、特异性分别为63%和94%。鳞癌敏感性最高为78%。(3)CYFRA21-1检测非小细胞肺癌的敏感性随临床分期升高而升高。(4)CYFRA21-1是监测肺癌病情、提示疗效的良好指标。(5)当CYFRA21-1作为筛检肺癌的指标时,阈值宜取非小细胞肺癌I-II期ROC曲线拐点,但对非小细胞肺癌早期诊断作用有限。结论CYFRA21-1是一较好的非小细胞肺癌肿瘤标记物,尤其适用于肺鳞癌。【关键词】标记物,肿瘤CYFRA21-1肺肿瘤ClinicalusefulnessofanewtumormarkerCYFR
3、A21-1inpatientswithlungcancerLiRui,LiRong,WangYawen.DepartmentofMedicalOncology,TheFirstClinicalMedicalCollege,Xi′anMedicalUniversity,Xi′an710061【Abstract】ObjectiveTosettheserumcut-offvalueofCYFRA21-1inlungcancerpatientsinchina,andtoevaluatetheclinicalusefulnessofCYFRA21-1asanewtumormarkeroflu
4、ngcancer.MethodsCYFRA21-1levelsweremeasuredwithtwomonoclonalantibodies(Ks19.1andBM19.21)intheserumof72patientswithlungcancer,50patientswithbenignlungdiseasesand33post-therapylungcancerpatients.Tosetthecut-offvalue,ROCcurvewasused.Results(1)SerumconcentrationsofCYFRA21-1inpatientswithlungcancer
5、weresignificantlyhigherthanthosewithbenignlungdiseases(P<0.001).CYFRA21-1levelsinpatientswithsquamouscellcarcinomaweresignificantlyhigherthanthoseinpatientswithanyothersubtypes.Themoreadvancedtheclinicalstages,thehigherthelevelsofCYFRA21-1.(2)IfthethresholdofCYFRA21-1wassetat5.5Lg/L,itssensiti
6、vityandspecificityforlungcancerwere63%and94%,respectively.Thesensitivityforsquamouscellcarcinomawas78%,whichwasthehighestamongallthepathologicalsubtypes.(3)ThesensitivityofCYFRA21-1innon-smallcelllungcancerincreasedwiththeadvancementofclini-calstages.(4)CYFRA21-1couldbeagoodindexinmonitoringpa
7、tient′sconditionandpredictingprognosisforlungcancer.(5)WhenCYFRA21-1wasusedasascreeningindexforlungcancer,thethresholdofCYFRA21-1shouldbesetattheupperleftcornerofthereceiveroperatingcharacteristiccurveofstageI-II.ThevalueofCYFRA21-1inea
