呼吸系统肿瘤标志物检测的临床应用价值

Study on the clinical value of respiratory tumor markers

目的探讨CEA、CYFRA21-1、NSE作为肺癌肿瘤标志物的临床意义。方法采用回顾性研究的方法研究200例肺良性疾病患者、131例确诊肺癌患者血清CEA、CYFRA21-1、NSE水平。结果与肺良性疾病比较,肺癌患者血清CEA、CYFRA21-1、NSE水平显著升高(P<0.001)。CYFRA21-1水平在非小细胞患者血清中显著高于小细胞患者(P<0.05)。CEA水平在肺腺癌患者中显著高于其它病理类型肺癌患者(P<0.01)。NSE水平在小细胞肺癌患者中显著高于非小细胞患者(P<0.05)。CEA和CYFRA21-1水平在肺癌患者中具有较高的灵敏度(54%和53.7%),CYFRA21-1在检测肺癌中具有较高的特异性(84%),联合检测多种肿瘤标志物比单一检测某种肿瘤标志物具有更高的敏感度。结论血清CEA、CYFRA21-1、NSE是有助于诊断肺癌的标志物,联合检测标志物可提高诊断的灵敏度和准确度。

Objective To study the clinical signifcance of carcinoembryonic antigen （CEA）, cytokeratin 19 fragment （CYFRA） and neuron-specific enolase （NSE）, can be used as tumor markers for lung cancer. Methods The serum levels of CEA,CYFRA21-1 and NSE in 200 patients with benign pulmonary diseases, 131 with lung cancer and 28 with other malignancies. Results Sensitivity of CEA,CYFRA21-1,NSE in diagnosis of lung cancer was significantly higher than benign pulmonary diseases （P〈0.001）. CYFRA21-1 had more higher level in NSCLC patients than SCLC patients （P〈0.01）. CEA had more higher level in adenocarcinoma than other pathological types （P〈0.01）. NSE had more higher level in SCLC patients than NSCLC patients （P〈0.05）. CEA and CYFRA21-1 had the highest sensitivity in lung cancer patients （54.0% and 53.7%）. CYFRA21-1 had the highest specificity（84%） for detecting lung cancers. The combination of several serum tumor markers had higher sensitivities than the single marker for the diagnosis of lung cancers. Conclusion Serum CEA, CYFRA21-1 and NSE are helpful markers for the diagnosis of lung cancer. The combination of the markers can improve the sensitivity and accuracy of the diagnosis.