肺癌肿瘤标志物CYFRA21-1的临床应用及其评价

APPRASIAL OF THE CLINICAL USEFULNESS OF THE PULMONARY CARCINOMA TUMOR MARKER CYFRA21-1

应用免疫放射分析法(IRMA)检测327例肺癌,297例肺部良性疾病患者CYFRA21-1的血清水平,肺癌组水平16.9±8.4ng/ml,非肿瘤组水平1.9±1.6ng/ml(p<0.001)。肺癌阳性率62.4％,良性疾患阳性率5％。测定灵敏度为62.4％,特异性为94.5％,准确率77.9％,结果均好于CEA、NSE、CA-242。肺癌病人随病期的增加,血清CYFRA21-1含量也随之上升(P<0.02)。对8例肺癌手术病人和10例化疗病人含量变化分析,在手术3～5周后,血清含量由术前的6.4±3.1ng/ml,降到1.8±0.6ng/ml,10例化疗病人,其中8例血清含量均有降低,由17.4±9ng/ml降至4.9±2.0ng/ml,临床证实均有良好的治疗效果,另2例临床证实治疗无效,血清CYFRA21-1水平相应增高。

Serum CYFRA21-1 levels ware determined with RIA in 327 patients suff ered from pulmonary carcinoma and 297 patients suffered from pulmonary benign diseases. The average CYFRA21-1 level in patients with pulmonary carcinoma was 16.9±8.39ng/ml and that of non-carcinoma group was 1.88±1.56ng/ml (p<0.00l). The positive rate in carcinoma group was 62.4% but only 5% in non-carcinoma group. Analysis of the results show that the sensitivity of this method was 62.4%,specificity 94.5% and accuracy 77.9%. The CYFRA21-1 levels in patients with pulmonary carcinoma increased gradually from stage Ⅰ to stage Ⅳ ( p<0.02). In 8 patients receiving operation, the serum CYFRA21-1 levels decreased from 6.4± 3.1ng/ml before operation to 1.8± 0.58ng/ml 3~5 weeks after operation. 8 patients who responded well to chemotherapeuy had their mean serum CYFRA21-1 levels decreaced from 17.4 9ng/ml to 4.9± 1.95ng/ml but other 2 patients with poor chemotherapeutic effect had elevation in serum CYFRA21-1 levels. These results clearly demonstrated that the determination of serum CYFRA 21-1 levels was of significant value in diagnosis and prognosis for pulmonany carcinoma.