全斌,喻艳林(皖南医学院附属弋矶山医院感染性疾病科,安徽芜湖241001)【摘要】目的:探讨血清肿瘤相关抗原(TAA)在肺结核临床诊疗中的应用价值。
方法:用化学发光免疫分析法测定172例肺结核患者血清CA125、CA199、CEA、FER、SCC水平,以50例肺癌患者、50例健康体检者作为对照。并对部分有意义的TAA进行影响因素分析。
结果:肺结核组血清CA125、FER水平均较健康组升高(P0.017),同时肺结核组的血清ca199、cea、sccp=水平要明显低于早期肺癌组(P0.017);通过非条件logistic回归分析,可知痰菌阳性、合并胸水或空洞与肺结核血清ca125p=高水平相关;FER的阳性率则主要受是否合并感染、病灶范围及活动性的影响(P0.05)。
结论:正确选择和应用taa检查p=不仅有助于肺结核和早期肺癌的鉴别诊断,还可作为肺结核活动性、严重性、病灶累积范围及是否合并感染判断的良好指标。
【关键词】肿瘤相关抗原;肺结核;诊断;
病情评估TumorassociatedantigensforpulmonarytuberculosisdiagnosisandevaluationQUANBin.YUYanlinDepartmentofInfectiousDiseases,YijishanHospital,WannanMedicalCollege,Wuhu241001,China【Abstract】Objective:Toassessthevaluesofserumtumor-associatedantigens(TAA)indiagnosisandtreatmentofpulmonarytuberculosis.Methods:ChemiluminescenceimmunoassaywasusedtodetecttheselMmlevelofSClRlmCA125,CA199,CEA,FERandSCCin172patientswithpulmonarytubercu—losis.Fiftyhealthysubjectsundergonephysicalexaminationandanother50patientswithearlylungcancerwereincludedascontrols.SignificantTAAwasanalyzedinpartofthesubjects.Resuits:HigherserumlevelsofCA125andFERwereseenintuberculosisgroup(P0.017),andthelevelsofserumCA199,CEAandSCCinthisgroupweresignificantlylowercomparedtoearlylungcancergroup(P0.017).UnconditionedLogisticregressionanalysisshowedthatpositiveacid—fastbacillus(AFB),occurrenceofpulmonarypleuralefusionorcavitywereassociatedwithhighCA125levels,whereaspositiveFERratewasinvolvedinpresenceofconcurrentinfection,scopeoflesionandpositiveAFBresults(P0.05).Conclusion:AppropriateapplicationofTAAdeterminationcannotonlycontributetoearlydifferentialdiagnosisofpulmonarytuberculosisandlungcancer,buttoestimationofactivepulmonarytuberculosisanditsseverity,lesioninvolvementandpresenceorabsenceofconcurentinfection.【Keywords】tumorassociatedantigen;
pulmonarytuberculosis;diagnosis;evaluation
标签:肺结核,抗原,肿瘤