CEA,CYFRA21-1和NSE联检在肺癌诊治中的应用

Clinical Application of Combined Determination of Serum/Chest Fluid CEA,CYFRA21-1 and NSE Levels for Diagnosis of Lung Cancer

目的 :探讨CEA、CYFRA2 1- 1和NSE 3种肿瘤标志物联检在肺癌诊治中的应用及胸水与血清水平同时测定在肺癌诊断中的差异。方法 :放免法测定CEA、CYRFA2 1- 1和NSE。共测定 37例健康成人、2 6例肺良性疾病及 5 3例肺癌患者的血清 ,并对 5 3例肺癌患者中的 33例同时进行了胸水 3项标志物的测定。结果 :健康成人组CEA为 (2 6 8± 1 75 )ng/ml,CYFRA2 1- 1为 (1 5 2± 0 86 )ng/ml,NSE为 (8 77± 4 13)ng/ml。肺良性疾病组CEA为 (5 4 8± 3 2 6 )ng/ml,CYFRA2 1- 1为 (5 32± 2 2 7)ng/ml,NSE为 (15 2 1± 11 36 )ng/ml,肺癌组CEA为 (2 4 95± 18 36 )ng/ml,CYFRA2 1- 1为 (17 81± 11 35 )ng/ml,NSE为 (19 85± 14 2 2 )ng/ml。肺癌组 3项标志物均较健康成人组有显著增高 (P <0 0 1) ,敏感性分别为 2 4 5 %、71 7%、35 8% ,3项联检敏感性为 83 0 % ,较肺良性疾病组CEA、CYFRA2 1- 1两项有显著增高 (P <0 0 1) ,NSE增高不明显 (P >0 0 5 ) ,肺良性疾病组较健康成人组均有显著性增高 (P <0 0 5及P <0 0 1)。同时测定 33项肺癌患者的胸水标本 ,胸水 3项标志物中的CEA、NSE水平较血清增高 ,但无显著性差异 (P >0 0 5 ) ,CYFRA2 1- 1显著增高(P <0 0 1) ,3项标志物水平与血清相比敏感性均增高?

Objective To explore the clinical value of combined determination of serum/chest fluid CEA、 CYFRA21-1 and NSE levels in the diagnosis of lung cancer. Methods Combined determination of serum levels of CEA、 CYFRA21-1 and NSE were done in 53 patients with lung cancer, 26 patients with benign lung diseases and 37 controls. Levels of these three tumor markers were also determined in the pleural fluid present in 33 of the 53 lung cancer patients. Results In the controls, the serum levels of CEA, CYFRA21-1 and NSE were 2.68±1.75, 1.52±0.86 and 8.77±4.13ng/ml respectively. In patients with benign lung diseases, the values were 5.48±3.26, 5.32±2.27 and 15.21±11.36 ng/ml respectively. In patients with lung cancer, they were 24.95±18.36, 17.81±11.35 and 19.85±14.22 ng/ml respectively. Serum levels of all these three markers were significantly higher in patients with lung cancer than those in the controls (P<0.01). The sensitivity were 24.5%, 71.7% and 35.8% respectively with combined sensitivity of 83.0%. Serum levels of CEA and CYFRA21-1 were also significantly higher in patients with lung cancer than those in patients with benign lung diseases (P<0.01); this was not true for the increase of NSE (P>0.05). Levels of all these markers were significantly higher in patients with benign lung diseases than those in the controls (P<0.05 and P<0.01). In the 33 specimens of pleural fluid, the CEA and NSE levels were higher than those in the corresponding serum samples but not significantly (P>0.05); only levels of CYFRA21-1 were significantly higher (P<0.01). Sensitivity of the respective marker in pleural fluid was higher than that in serum. Conclusion For diagnosis of lung cancer, determination of serum CYFRA21-1 levels or combined determination of the three tumor markers would be most valuable to test levels in pleural fluid, if available, would be more sensitive.