肺泡冲洗液肿瘤标志物联合检测对肺癌诊断的临床价值

The Clinical Value of Carcinoembryonic Antigen, Cytokeratin 19 Fragment and Neuron Specific Enolase Levels in Lung Cancer

目的了解肺泡冲洗液中肿瘤标志物癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)和神经元希醇化酶(NSE)联合检测在肺癌诊断中的应用价值。方法应用电化学发光技术测定56例肺癌患者、83例肺部良性疾病患者和30例正常对照者肺泡冲洗液以及血清中的CEA、CYFRA21-1、NSE水平。结果肺癌组肺泡冲洗液中的CEA、CYFRA21-1和NSE水平均高于肺良性疾病组和对照组,其中CEA和CYFRA21-1水平与肺良性疾病组差别有统计学意义(P<0.05),而NSE差别无统计学意义(P>0.05)。CEA、CYFRA21-1和NSE对肺癌诊断的阳性率分别为62.50%,64.28%,53.57%,而三者联合检测对肺癌的诊断阳性率为94.64%,单项与联合检测的阳性率差别有统计学意义(P<0.05)。在肺癌患者组中肺泡冲洗液的单项阳性率和联合检测的阳性率均较血清组高,但差别均无统计学意义(P>0.05)。结论联合检测肺泡冲洗液CEA、CYFRA21-1和NSE3种肿瘤标志物,对肺癌的诊断具有较高的敏感度和临床应用价值。

Objective To investigate the application value of the combination detections of carcinoembryonic antigen （CEA）, Neuron specific enolase （NSE） and cytokeratin 19 fragment （CYFRA21-1） in lung flushing fluid in patients with lung cancer. Method The lung flushing fluid and serum level of CEA CYFRA21-1 and NSE were assayed in 56 patients with lung cancer, 83 patients with benign lung disease and 30 normal individuals by electroehemilumineseence immunoassay. Results The lung flushing fluid levels of CEA CYFRA21-1 and NSE in patients with lung cancer were significantly higher than those in patients with benign lung disease and control group （P〈0.05）, while there was no significant difference of NSE （P〉0.05）. The positive rate of CEA ,CYFRA21-1 and NSE to the lung cancer were 62.50%, 64.28%, and 53.57%, while the positive rate of the combination with CEA CYFRA21-1 and NSE was 94.64%. The single positive rate and the positive rates of combined detection of CEA CYFRA21-1 NSE in lung flushing fluid were both higher than those in serum, but there was no significant difference （P〉0.05）. Conclusion To adept the combined test of CEA CYFRA21-1 and NSE in lung flushing fluid is more sensitivity and more valuable application in clinic.