肺癌的血清学诊断

The serologic diagnosis for lung cancer

目的:评价血清癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、细胞角蛋白片段(CYFRA 21-1)在肺癌诊断中的价值。方法:肺癌患者120例、50例肺部非癌性良性疾病患者以及50例健康人群作为对照组,全部清晨空腹采集血清样本,冷冻保存。用电化学发光免疫测定法检测血清CEA、NSE和CYFRA 21-1的含量水平。结果:在肺癌患者血清中,CEA、NSE和CYFRA 21-1水平明显高于肺部非癌症患者组及正常对照组(P<0.01)。肿瘤标志物在肺部良性疾病组和正常对照组无显著性差异(P>0.05)。CEA在肺腺癌患者含量最高、NSE在肺小细胞癌中的含量最高、CYFRA 21-1在肺鳞癌中的水平最高。CEA、NSE和CYFRA 21-1三项联合检测比单项检测诊断肺癌的阳性率明显增高,总阳性率为90.0%。结论:血清学检测对肺癌的诊断有一定的临床意义;肺癌患者血清CEA、NSE和CYFRA 21-1水平和肺癌的病理分型有一定的相关性;CEA、NSE和CYFRA 21-1三项联合检测可提高肺癌诊断的阳性率。

Objective.. To evaluate the clinical significance of carcinoembryonic antigen （CEA）, neuron-specific enolase （NSE） and Cytokerat in 19 fragment 21-1（CYFRA21-1） in serum for the diagnosis of lung cancer. Methods： The serum samples were collected from 120 lung cancer patients including different pathological types, 50 patients with benign lung diseases and 50 healthy people in early morning without eating, and then preserved in the refrigerator. The 120 lung caner patients were divided into two groups： small cell lung caneer（SCLC） group（15） and non-small cell lung caner（NSCLC） group（105）. The latter group included 47 squamous cell carcinoma patients and 58 pulmonary adenocarcmoma patients. The serum levels of CEA, NSE and CYFRA21-1 were detected by using electro-chemoluminescence in these samples together. Results.. The level of these tumor markers in the patients with lung cancer was higher than that in benign pulmonary disease group and normal group（P〈0.01 ）. But there was no significant statistic difference between the benign pulmonary disease group and the normal group. CEA, NSE, CYFRA21-1 was in the highest level in the patients with pulmonary adenocarcinoma, small cell lung cancer carcinoma and squamous cell carcinoma respectively. The positive rate of the comb;nation of CEA, NSE, and CYFRA21-1 for lung cancer patients was 90. 0% totally. Conclusions.. The serologic detection is useful for the diagnosis of lung cancer. There is relativity between the pathology types and the serum levels of these three serum tumor markers. It is suggested that the combined measurement of CEA, NSE, and CYFRA21-1 is more helpful than single tumor marker detection.