血清和支气管肺泡灌洗液中癌胚抗原及透明质酸测定对肺癌的诊断意义

应用放免法测定了７４例肺癌和７６例良性肺病患者血清（Ｓ）和支气管肺泡灌洗液（ＢＡＬＦ）中癌胚抗原（ＣＥＡ）及透明质酸（ＨＡ），同时测定了５８例健康人Ｓ－ＨＡ。结果显示：肺癌患者Ｓ－ＣＥＡ极显著高于良性肺病患者（Ｐ＜０．００１），肺癌患者Ｓ－ＨＡ极显著高于健康人和良性肺病患者（Ｐ均＜０．００１）。肺癌患侧ＢＡＬＦ－ＣＥＡ和ＢＡＬＦ－ＨＡ极显著高于肺癌健侧、良性肺病患侧和健侧（Ｐ＜０．００１或Ｐ＜０．００２）。根据各项指标在肺癌时的阳性率，选用Ｓ－ＣＥＡ、ＢＡＬＦ－ＣＥＡ和ＢＡＬＦ－ＨＡ作为诊断指标，当３项阳性时对肺癌诊断的敏感性为５３％，特异性为９７％、阳性预示值为９５％，用性预示值为７６％，准确性为７２％。

ASSESSMENT OF CARCINOEMBRYNIC ANTIGEN AND HYALURONIC ACID IN SERUM AND BALF AND ITS SIGNIFICANCE IN THE DIAGNOSIS OF LUNG CANCER

Radioimmunoassay was used to measure carcinoembrynic antigen(CEA) and hyaluronic acid(HA) in serum and bronchoalveolar lavage fluids(BALF)in 74 patients with lung cancer, 76 patients with benign pulmonary disease and 58 healthy people as controls. The results showed that both the levels of serous CEA and HA in patients with lung cancer were significantly higher than those in patients with benign lung disease and in the controls (P<0.001).Their levels in BALF taken from the affected lungs were also significantly higher than those taken from the normal opposite lungs in patients with lung cancer,and those taken from both lungs in the patients with benign lung disease(P<0.001),These suggest that serous CEA and BALFCEA and BALF-HA may be used as predictors in the diagnosis of lung cancer with sensitivity 53%,specificity 97%,positive predictive value 95%, negative predictive value 76% and accuracy 72%.