| Background: In recent decades morbidity and mortality of lung cancer is ever increasing all over the world. In most of developed countries, the study on the death's cause shows lung cancer is listed at the first place in male, second or third place in female, experts predict that lung cancer will become a most serious disease which threaten people's health and life this century in our country. At present, the 5-year survival rate remains low, only 13%, but there is a high 5-year survival rate in patients with early diagnosis, about 60%-90%. Therefore, early diagnosis plays a important role. 95% of patients with central lung cancer can be identified by bronchofiberscope, while diagnosis rate only is 30%-70% in those with peripheral lung cancer. Among so many tumor markers, we choose telomerase activity and carcina-embryonic-antigen(CEA).Because their higher sensitivity and specificity and there are no documents about combined assay with Telomerase activity and CEA in BALF. The purpose of this study is to evaluate the two tumor markers' usefulness in diagnosis of peripheral lung cancer.Materials and methods: All specimen of BALF obtained from Henan Provincial Chest Hospital. Patients"diagnosis. Of Peripheral group were confirmed by fiberoptic bronchoscope, percutaneous needle biopsy, open lung operation and follow-up. Of 32cases, male 18, female 14, mean age 58+12; adenocarcinoma 16, squamous cancer 8, small cell lung cancer 2, unidentified type 6 cases. In control group, of 29 cases, male 19, female 10; mean age 42 + 9.5; pulmonary tuburculosis!4, inflammatory pseudotumor 7, aspergillosis 3, silicosis 3, interlobar effusion 2. The diagnosises of them were determined by pathologic and immunologic methods and followup survey. Telomerase activity was detected with TRAP, and CEA with radioimmunassay. X2and t test dealed with statistic data.Results :(1 )Concentration of CEA in lung cancer group was higher than the control group's. There was significant difference between the two groups by t test (p<0.05). Cut-off was x + 2s. Sensitivity and specificity of CEA detection was 62.5% and 86.2% respectively.(2)The positive rate of telomerase activity in lung cancer groupwas higher than control group's .It showed that difference between the two groups was significant by x2test(p<0.05),and sensitivity and specificity was 68.8%and 89.7%respectively.(3)There was no correlativity between telomerase activity and CEA assay.(4)The positive rate of combination detection increased by 93%, but specificity declined by 76%.(5)Both Positive rate of telomerase activity and CEA was 37.5% in peripheral lung cancer group, but no case in control group, namely the specificity was up to 100%.Conclusion: If telomerase activity or CEA is alone detected, its specificity is excellent but sensitivity undesirable. When combination detection is performed, the sensitivity is extremely high but the specificity decreased. Moreover, both positive rate of telomerase and CEA is relatively low, but its specificity is perfect. Therefore, In patients with peripheral lung cancer, especially, those without diagnosis by bronchoscope examination, telomerase and CEA detection in BALF might be helpful in reaching definite diagnosis.
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