Résumé
Objective To evaluate the clinical significance of carcinoembryonic antigen (CEA),cancer antigen 125 (CA125),carbohydrate antigen 19-9 (CA19-9) and eytokeratin 21-1 fragment (CYFRA21-1) assays of sputum in patients with lung cancer. Method Fifty-two cases with lung cancer and 46 cases with benign lung diseases underwent detection of CEA ,CA125 ,CA19-9 and CYFRA21-1 in sputum by using the method of chemi-luminescent enzyme immunoassay. Results The levels of CEA,CA125,CA19-9 and CYFRA21-1 in sputum of 52 cases with lung cancer were (27.6±31.2) μg/L, (76.4±65.2)kU/L, (56.1±31.6) kU/L and ( 25.2±9.1 )μg/L respectively. But the levels of those of 46 cases with benign lung diseases were (6.1±7.5)μg/L, (23.7±7.9) kU/L, (17.3±10.2) kU/L and (1.2±1.7)μg/Lrespectively. The levels of these tumor markers in sputum in patients with lung cancer were significantly higher than those in patients with benign lung diseases(P 0.05 ). Among the cancer patients, the sensitivity of sputum CEA in patients with adenocareinoma was significantly higher than that in patients with squamons cell carcinoma (X2= 4.193, P < 0.05 ) ; while the sensitivity of sputum CYFRA21-1 in patients with squamous cell carcinoma was significantly higher than that in patients with adenocarcinoma ( X2 = 4.806,P < 0.05 ). The sensitivity of CA125 in advanced lung cancer( Ⅲ +Ⅳ stage) was higher than that in early lung cancer( Ⅰ+Ⅱstage) (X2= 5.202,P < 0.05 ). Compared with the single tumor marker assaying, the combination of CEA,CA 125, CA 19-9 and CYFRA21-1 in sputum could significantly improve the sensitivity and accurate value in the diagnosis of lung cancer (P<0.05). Conclusion To assay CEA,CA125,CA1g-9 and CYFRA21-1 in sputum is valuable in diagnosis of lung cancer, and the combination of CEA,CA125,CA19-9 and CYFRA21-1 in sputum can significantly improve sensitivity and accurate value in the diagnosis of lung cancer.
Résumé
Fibro-optic bronchoscopy (FB) examinations were undertaken in 42 cases with lung cancer and 25 cases with benign lung disease; methylation-specific PCR was performed in plasma, sputum and bronchoalveolar lavage fluid (BALF) specimen for detection of p16 gene promoter methylation in all patients.Of the 42 cases of lung cancer, the positive rates of p16 gene promoter methylation were 59.5% in BALF, 52.4% in plasma and 47.6% in sputum, respectively; while p16 gene promoter methylation was detected only in one plasma sample from 25 cases with benign lung disease ( P ＜ 0.05 ).The sensitivity,specificity and overall accuracy of FB were 59.5%, 100.0% and 74.6%, respectively.The sensitivity,specificity and overall accuracy of FB combined with aberrant p16 gene methylation in diagnosis of lung cancer were 92.9%, 96.2% and 94.0%, respectively.The FB examinations combined with detection of aberrant p16 gene methylation can further improve the accuracy to diagnosis of lung cancer.
Résumé
AIM:To investigate the aberrant methylation in the promoter of p16 in plasma,sputum,bronchoalveolar lavage fluid(BALF),pleural effusion and biopsy specimens from suspected lung cancer patients and to evaluate the clinical significance in the early diagnosis of lung cancer.METHODS:Using methylation specific PCR(MSP)for the detection of promoter methylation of p16 gene in plasma,sputum,BALF,pleural effusion and biopsy specimens from suspected lung cancer patients.RESULTS:Of the 67 cases of suspected lung cancer patients,42 were proved by pathology.The positive percentages of p16 gene promoter methylation of the lung cancer patients are as follows:52.4%(22/42)in plasma,47.6%(20/42)in sputum,59.5%(25/42)in BALF,71.4%(10/14)in pleural effusion and 61.9%(26/42)in biopsy specimens,respectively;while promoter methylation in p16 gene was found only one in plasma and one in pleural effusion in 25 patients with various benign lesions(P0.05).CONCLUSION:Detection of the aberrant methylation in the promoter of p16 gene in plasma,sputum,BALF,pleural effusion and biopsy specimens from lung cancer patients by MSP method is a kind of rising technology with development potential for lung cancer early diagnosis.