原发性肺癌患者外周血肿瘤标记物联合检测的临床意义

Clinical Value of the Combined Detection of Serum Tumor Markers in Patients with Primary Lung Cancer

目的探讨外周血CEA、CYFRA21-1、NSE联合检测对原发性肺癌的诊断、病理分型、分期和疗效判断的临床应用价值。方法采用放射免疫技术,检测72例原发性肺癌患者化学治疗前后、38例良性肺部疾病患者及30例健康人血清CEA、CYFRA21-1、NSE水平。结果肺癌组治疗前CEA、CYFRA21-1、NSE水平显著高于良性肺部疾病组及正常对照组(P均<0.01),且不同病理类型肺癌3种肿瘤标记物的水平有显著性差异。3种肿瘤标记物联合检测与各单项指标检测比较,对肺癌诊断的敏感性显著增高(P<0.01),肺癌NSE检出阳性率最高(63.9%),但特异性有所下降。肺癌组化疗有效者3种肿瘤标记物水平显著下降,病情稳定和进展者三者水平无变化或升高。结论血清CEA、CYFRA21-1、NSE联合检测用于肺癌的诊断有较好的临床参考价值,并有助于肺癌病理类型的评估,亦可作为肺癌病情监测和疗效判断方面有价值的指标。

Objective To investigate the value of combined detection of serum CEA、CYFRA21-1 and NSE in the diagnosis,pathological classification,stage and therapeutic efficiency in primary lung carcinoma.Methods Using immunoradiometric assey,the serum CEA、CYFRA21-1 and NSE levels were measured in 72 cases of primary lung cancer before and after chemotherapy,as well as in 38 cases of benign pulmonary diseases and 30 cases of healthy controls.Results The levels of CEA、CYFRA21-1 and NSE in patients with primary lung carcinoma before chemotherapy were significantly higher than those in benign pulmonary diseases and normal controls(P<0.01).Signle analysis showed that high positive rates of CEA,CYFRA21-1 and NSE were seen in adenocarcinoma,squamous carcinoma and small cell lung cancer,respectively.Combined detection of these tumor markers has an increased sensitivity(P<0.01).After chemotherapy,the serum levels of the markers were decreased significantly in the CR and PR patients,but increased or not changed in patients with advanced disease or metastases.Conclusion Combined detection of serum CEA、CYFRA21-1and NSE has a high sensitivity in the diagnosis of lung cancer.The three markers correlate closely with the pathological type and have a value in the treatment of patients who is unable to receive pathological examination.CEA、CYFRA21-1and NSE can be used as valuable markers for monitoring and evaluation of therapeutic efficacy in primary lung cancer.