血清神经元特异性烯醇酶(NSE)、细胞角蛋白19(CYFRA21-1)和癌胚抗原(CEA)联合检测对肺癌诊断的临床意义

CLINICAL SIGNIFICANCE OF THE NEURON-SPECIFIC ENOLASE(NSE), CYTOKERATIN 19 FRAGMENT MARKER(CYFRA21-1) AND CARCINOEMBRYONIC ANTIGEN(CEA) IN THE DIAGNOSIS OF LUNG CANCER

目的:评价NSE、CYFRA21-1和CEA在各种病理类型肺癌中诊断的应用价值,通过联检观察它们在肺癌诊断中的敏感性和有效性。方法:收集血清标本127例,其中肺鳞癌22例,肺腺癌19例,小细胞肺癌16例,不能分型肺癌组13例,肺部良性疾病组27例和正常对照组30例。采用酶联免疫吸附试验进行检测。结果:NSE、CYFRA21—1和CEA在肺癌各病理类型组的血清水平与正常对照组有差异(P<0.05),NSE和CEA在肺癌各病理类型组的血清水平高于良性病变组(P<0.05),CYFRA21-1在肺癌各病理类型组的血清含量与肺部良性疾病组无差异(P>0.05)。NSE在小细胞肺癌组的血清水平与肺部良性病变组和正常对照组有显著性差异(P<0.01),NSE在小细胞肺癌组的敏感性为75%,与肺腺癌组比较有差异(P<0.05),特异性为96.5%。CYFRA21-1和CEA在肺癌的灵敏度分别为27.1%和22.8%,CYFRA21-1在肺鳞癌中灵敏度最高,为36.4%,CEA在肺腺癌中最高,为31.6%。NSE、CYFRA21-1和CEA三项联检,可明显提高肺癌诊断的灵敏度,同时特异性也较高。结论:NSE是对小细胞肺癌具有高特异性和高敏感性的肿瘤标志物,在小细胞肺癌诊断上具有重要的参考意义。CYFRA21-1和CEA在肺癌诊断上灵敏度较低,但特异性强,在肺癌诊断上有一定的参考价值,上述3项标志物联检可提高肺癌的检出率,有一定的临床?

Objective: To evaluate the clinical value of N SE, CYFRA21-1 and CEA in the diagnosis of varied groups of lung cancer. To observe t he sensitivity and effectiveness by combined detection of the three tumor marker s. Methods: The 127 serum samples were collected and measured: inclu ding 22 squamous cell carcinomas, 19 adenocarcinomas, 16 small-cell carcimomas, 13 unclassified lung cancers, 27 benign pulmonary diseases and 30 normal control cases. Serum was detected by ELISA. Results: There was a difference in serum level of NSE, CYFRA21-1 and CEA between lung cancer groups and control groups(P<0.05). The serum level of NSE and CEA is higher in lung cancer gr oup than that in benign group(P<0.05). There was no difference in the serum level of CYFRA21-1 between lung cancer groups and control group(P>0.05). T here was significant difference in the serum level of NSE between small-cell ca rcimoma cases and that of benign pulmonary disease cases and normal control grou p(P<0.01). The sensitivity of NES in SCLS is 75%, which shows a difference from that in lung cancer groups(P<0.05). The specificity is 96.5%.The sensi tivity of CYFRA21-1 and CE A is, respectively 27.1% and 22.8%. CYFRA21-1 showed the highest sensitivity (36 .4%) in squamous cell carcinomas, CEA is the highest in adenocarcinomas (31.6%). The co mbined detection of the three tumor markers NSE, CYFRA21-1 and CEA may improve the sensitivity for lung can cer detection, and specificity is high. Conclusion: Being the tumor markers wit h high specificity and sensitivity, NSE and SCLC show great reference significan ce in dete ction of lung cancer. CYFR21-1 and CEA has a lower sensitivity but high specific ity, thus shows some clinical value. The combined detection of three tumor marke rs mentioned above can increase diagnosis rate of lung cancer, which shows some clinical value.;