肿瘤标记物和CT联检对肺癌的诊断价值

Diagnostic value of combined detection of serum tumor markers and CT scan for lung cancer

目的:探讨多种肿瘤标记物检测联合CT扫描在肺癌诊断中的价值。方法:90例肺癌和20例肺良性病变患者与20名正常人,检测其血清NSE、CEA和CYFRA21-1三项肿瘤标记物含量,同时行肺部CT扫描检查。结果:肺癌组血清三项肿瘤标记物含量均高于正常对照组和肺良性病变组,P=0·000;NSE在小细胞肺癌中高表达(36·21±19·01)μg/L,CEA在肺腺癌中高表达(50·09±25·36)μg/L,CYFRA21-1在肺鳞癌中高表达(17·72±12·05)μg/L,三项肿瘤标记物的血清浓度与肺癌病理类型有关,P=0·001;肿瘤标记物和CT扫查对肺癌分型诊断总体符合率分别为79·2%和62·5%,联合检测的总体符合率为87·8%,联合检测优于单项检测,P=0·039;三项肿瘤标记物的含量在肺癌各期间差异无统计学意义,P>0·05。结论:多种肿瘤标记物联检,可提高肺癌分型的诊断符合率,结合CT分期有助于选择针对性的治疗方案。肿瘤防治杂志,2005,12(19)

OBJECTIVE： To investigate the diagnostic value of serum tumor markers combined with spiral CT scan （SCT） for lung cancer. METHODS： NSE, CEA, CYFRA21-1 contents of blood serum were detected from 90 cases of lung cancer, 20 cases of lung benign diseases and 20 cases of normal people, and the lung disease patients were scanned with spiral CT concurrently. RESULTS： Contents of three tumor markers in lung cancer patients were higher than those in the that in normal people and lung benign disease patients （P =0. 000）. NSE expresssion was the highest in small cell lung cancer, （36.21±19.01） μg/L, CEA expresssion was the highest in adenocarcinoma, （50.09±25.36） μg/L, and CYFRA21-1 expresssion was the highest in squamous cell carcinoma. （17.72±12.05） μg/L. The contents of three tumor markers were related to pathology types,P=0.001. The diagnostic concordance rates with tumor type were 79.2% and 62.5% through tumor markers and SCT respectively, combined detection concordance rate was 87.8%, combined detection was better than single detection,P=0.039. The contents of three tumor markers in lung cancer patients had no significant difference among tumor stages, P〉0. 05. CONCLUSION： Combined detection of serum tumor markers maybe increases the diagnostic accuracy for lung cancer types, and it is useful to chose adaptive treatment plan with CT scan.