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目的:探讨血清组织多肽特异性抗原(TPS)、神经元特异烯醇化酶(NSE)、癌胚抗原(CEA)和β2微球蛋白(β2-mG)水平与小细胞肺癌(SCLC)生物学行为的关系及其对肺癌的诊断价值。方法:采用ELISA和免疫放射分析法(IRMA)测定94例小细胞肺癌患者,86例肺良性疾病患者和89例正常对照组4项标志物的水平。结果:小细胞肺癌组血清TPS、NSE水平[(437.8±516.6)U/L、(76.8±91.4)μg/L]不但高于肺良性疾病组[(143.6±78.7)U/L、(13.3±10.8)μg/L]和正常对照组[(98.4±58.9)U/L、(10.1±5.7)μg/L)],P<0.01。CEA和β2-mG水平测定中,SCLC组亦高于良性疾病组和正常对照组(P<0.01),则以TPS、NSE水平为指标诊断SCLC的敏感性、特异性及准确性分别为84.4%、87.8%、83.6%和79.3%、93.7%、88.3%,高于CEA和β2-mG。此外,发生转移的SCLC血清中TPS、NSE水平高于未转移组,转移灶数目越多,则TPS、NSE水平越高。每天吸烟30～40支可达10～24倍,吸烟量与肺癌之间存在着量效关系。结论:血清TPS、NSE、CEA和β2-mG对于小细胞肺癌的早斯诊断有一定的价值,4项联合检测则有明显的互补性,其水平与肺癌转移密切相关。
Objective: To investigate the relationship between serum TPS, NSE, CEA and β2-microglobulin (G-CSF) levels and the biological behavior of small cell lung cancer (SCLC) Of the relationship between the diagnosis of lung cancer and its value. Methods: The levels of four markers in 94 patients with small cell lung cancer, 86 patients with benign lung disease and 89 normal controls were determined by ELISA and immunoradiometric assay (IRMA). Results: Serum levels of TPS and NSE in small cell lung cancer group were significantly higher than those in benign lung disease group [(437.8 ± 516.6) U / L, (76.8 ± 91.4) μg / L) [(143.6 ± 78.7) U / 10.8) μg / L], and normal control group (98.4 ± 58.9) U / L, (10.1 ± 5.7) μg / L)], P <0.01. The sensitivity, specificity and accuracy of TPS and NSE levels in diagnosing SCLC were 84.4% , 87.8%, 83.6% and 79.3%, 93.7% and 88.3% respectively, higher than CEA and β2-mG. In addition, the level of TPS and NSE in the metastatic SCLC serum is higher than that in the non-metastatic group. The more the number of metastases, the higher the TPS and NSE levels. 30 to 40 cigarettes a day up to 10 to 24 times, there is a dose-effect relationship between smoking and lung cancer. CONCLUSIONS: Serum TPS, NSE, CEA and β2-mG are valuable for the early diagnosis of small cell lung cancer. The four combined tests are significantly complementary to each other and their levels are closely related to the metastasis of lung cancer.