肺癌患者血清细胞角蛋白19片段和癌胚抗原的检测与临床价值

Detection and Clinical Significace of CYFRA21-1 and CEA in Patients with Lung Cancer

目的:探讨血清细胞角蛋白19片段(CYFRA21-1)和癌胚抗原(CEA)在肺癌诊断中的价值及其临床意义。方法:采用放射免疫分析法,检测了78例肺癌患者和40例健康人对照的血清CYFRA21-1和CEA的浓度及阳性率的变化。结果:肺癌患者CYFRA21-1和CEA明显高于对照组(P<0.05)。肺癌患者血清CYFRA21-1阳性率明显高于CEA。CYFRA21-1对肺癌诊断敏感度、特异度、有效率为66.7%、92.5%、75.4%,CYFRA21-1对鳞癌诊断敏感度、有效率高于腺癌。而CEA对肺癌诊断敏感度、特异度、有效率为25.6%、100.0%、50.9%,CEA对腺癌诊断敏感度、有效率高于鳞癌。20例手术患者血清CYFRA21-1和CEA手术后浓度(3.56±0.57μg/L,6.11±2.03μg/L)明显低于手术前(7.24±2.13μg/L,13.25±4.12μg/L),P<0.05。结论:CYFRA21-1和CEA对肺癌的诊断有帮助。CYFRA21-1和CEA在肺癌诊断上敏感度较低,但特异度强,在肺癌诊断上有一定的参考价值,上述2项标志物联检可提高肺癌的检出率,有一定的临床价值。

Objective： To evaluate the diagnostic and clinical significance of CYFRA21-1 and CEA in lung cancer. Methods The changes of serum CYFRA21-1 and CEA levels and their positive rates were detected in 78 patients with lung cancer and 40 healthy people by RIA methods respectively. Results Serum CYFRA21-1 and CEA levels were significantly higher in patients than those in the control group. The positive rate of serum CYFRA21-1 in lung cancer was higher than that of CEA. The sensitivity, specificity and diagnostic accuracy of CYFRA21-1 in lung cancer were 66.7% , 92.5% and 75.4% , compared with 25.6%, 100.0% and 50. 9% for CEA. CYFRA21-1 were more sensitive and diagnostically accurate for squamous cell cancers than for adenocarcinomas, compared with CEA for the contrary. The levels of CYFRA21-1 and CEA in patients after surgery were significantly lower than those before surgery. Conclusions CYFRA21-1 and CEA may be useful for assessing the patients＇ conditions. Diagnostically CYFR21-1 and CEA appeared less sensitive but highly specific, thus showing some clinical value. The combined detection of these tumor markers can increase diagnosis rate of lung cancer.