联合检测血清CYFRA21-1、CA153及NSE在肺癌诊治中的临床意义

Clinical significance of combined measuring CYFRA21-1,CA153 and NSE for lung cancer

目的:探讨肿瘤标志物联合检测在肺癌诊治的临床意义。方法:用放免分析法检测96例肺癌患者和50例肺部良性疾病(对照组)患者血清CYFRA21-1、CA153及NSE的含量,并观察其在不同病理、不同TMN分期以及化疗前后的变化。结果:肺癌组肿瘤标志物单项和联合检测阳性率高于对照组(P<0.005);不同的病理细胞类型,鳞癌组以血清CYFRA21-1阳性率最高,可达83.87%,腺癌以血清CA153阳性率最高,可达72%,小细胞癌以血清NSE阳性率最高,可达80%,3项联合检测肺癌阳性率可达87.57%,比单项检测的阳性率有显著的提高(P<0.01)。联合检测肺癌的敏感性和准确性较单项检测差异有显著性(P<0.01),而特异性差异无显著性。肿瘤标志物阳性率随着临床期别的升高而升高,3项联合检测Ⅰ/Ⅱ期肺癌,较单项检测高,差异有显著性(P<0.05)。化疗后随访比较,肿瘤标志物含量与疗效呈负相关。结论:3项肿瘤标志物的联合检测,可提高肺癌的早期发现率,为肺癌的诊断、分型、分期提供可靠的依据。

Purpose： To study the clinical significance of combined tumor marker measurements for lung cancer. Methods： The levels of CYFRA21-1, CA153 and NSE in the serums which were from 96 cases of lung cancers, 50 cases of benign lung disease.,（ BLD. control） were measured with immunoradiometric assay, and change of the levels in serum were observed with different pathohistological cell types. TNM stage and chemotherapy. Results： The positive rates of the tumor markers in lung cancer group were significantly higher than that in BLD group（P 〈 0. 005）. Among different pathohistological cell types, the highest positive rate was of CYFRA21-1 in squamous cell carcinoma（83.87 %）, CA153 in adenocarcinoma（ 72% ） and NSE in small cell lung cancer（ 80% ）, the positive rate of combined measurement markers for lung cancer was 87.57%. significantly higher than that of single measuring （ P 〈0.01）, there were differences in sensitivitity and veracity（P 〈0.01）. no difference in specificity. The more advanced the stage, the higher the positive rates. There were differences between combined and single measurement in Ⅰ/Ⅱ stage of lung cancer （P 〈 0.05）. Follow-up of the patients treated with chenaotherapy showed that the levels of the markers were inverseh, related to the effects. Conclusions： The diagnostic sensitivity of lung cancer for early stage is raised by combined measuring, it may provide valuable proof in the diagnosis, types and stages of lung cancers.