血清肿瘤标志物在肺癌中的检测和临床意义

Detection and clinical significance of measurement of serum tumor markers in patients with lung cancer

目的探讨4种血清肿瘤标志物糖链抗原125Ⅱ(CA125Ⅱ)、细胞角质素片断抗原(CYFRA21-1)、癌胚抗原(CEA)及神经元特异性烯醇酶(NSE)在肺癌辅助诊断中的应用价值和意义,并选择最理想的血清肿瘤标志物组合。方法用电化学发光免疫法(ECLIA)测定48例肺部良性病变、89例晚期肺癌患者血清CA125Ⅱ、CYFRA21-1、CEA及NSE的水平。结果肺癌患者的4种血清肿瘤标志物水平均明显高于肺部良性疾病组,有显著性差异(P<0.01)。CYFRA21-1在鳞癌中阳性率最高,明显高于其他类型的肺癌(P<0.01)。CA125Ⅱ、CEA在腺癌中阳性率最高,NSE则在小细胞癌(SCLC)最为明显。结论合理利用血清肿瘤标志物检查肺癌患者,既有助于诊断,又可做到合理检查、避免资源浪费。

Objective To evaluate the clinical value and significance of four serum tumor markers CA125 Ⅱ , CYFRA21 - 1, CEA and NSE used alone or in combination in assistant diagnosis of lung cancer. Methods The level of four serum tumor markers were detected by electrochemiluminescence immunoassay （ECLIA） in 48 benign lung diseases（BLD）, 89 lung cancer patients in advanced stage （20 SCLC and 69 NSCLC）. Results The level of the four serum tumor markers in lung cancer patients was significantly higher than those in BLD group （ P 〈 0.01）. The level of CYFRA21 - 1 in patients with squamous- cell carcinoma was significantly higher than that in other subtypes （ P 〈 0.01 ）. The level of CA125 Ⅱ and CEA in patients with glandular carcinoma was significantly higher than that in other subtypes （ P 〈0.05）. The level of NSE in patients with small - cell lung cancer was significantly higher than those in the other subtypes of lung cancer （ P 〈 0.01 ）. Utilizing serum tumor markers reasonably to detect lung cancer patients was not only better for diagnose, but also for reasonable detection and avoiding wasting resources.