肿瘤标志物在肺癌诊断中的价值

Diagnostic Value of Serum Tumor Markers for Lung Cancer

目的探讨外周血肿瘤标志物癌胚抗原（carcinoembrynic antigen，CEA）、神经元特异性烯醇化酶（neuron—specific enolase，NSE）、细胞角质蛋白19片段（cytokeratin fragmen 19，CYFRA21-1）、糖链抗原125（carbohydrate antigen，CA125）、糖链抗原19-9（carbohydrate antigen，CA19-9）、糖链抗原153（carbohydrate antigen，CA153）在肺癌诊断、预后及手术效果判断中的应用价值。方法采用Elecsys2010电化学发光仪检测90例肺癌患者、65例肺部良性疾病患者、30例健康人血清中6种肿瘤标志物的水平。结果CEA、NSE、CYFRA21—1、CA125、CA19-9、CA153等6种标志物在肺癌患者中的含量显著增高。明显高于正常对照组及肺部良性疾病组，差异具有统计学意义（P〈0．01）。CEA、CYFRA21—1、CA125、CA153在治疗前后有显著差异。NSE下降在参考值上限，CA19—9在治疗前后无统计学差异。CEA、CA153、CA199三种标志物在4种类型肺癌中的水平均明显升高，差异无统计学意义（P〉0．05）；CYFRA21-1在鳞癌中的水平最高，明显高于其他类型的肺癌，具有统计学意义（P〈0．01）；NSE在小细胞肺癌中水平高于其他类型，差异具有统计学意义（P〈0．01），CA125在腺癌中水平明显高于其他类型，差异具有显著的统计学意义（P〈0．01）。结论CYFRA21-1＋CA125＋NSE联合检测能提高肺癌的早期诊断率。

Objective To evaluate CA125, CA19-9, CEA, CYFRA21-1, NSE and CA153 used alone or in combination for the diagnosis of lung cancer. Methods The serum levels of six tumor markers ： CEA, CYFRA21-1, NSE, CA153, CA19-9 and CA125 were detected by Elecsys 2010 electrochem- iluminescence analysator in 90 patients with lung cancer, 65 patients with benign lung disease （BLD） and 39 healthy adults. Results The serum levels of the six tumor markers were significantly higher in lung cancer patients than in benign intestinal patients and healthy adults （P 〈 0.0 1 ）. In patients after colorectal cancer operation, the serum levels of CEA, CYFRA21-1, CA125 and CA153 were significantly lower （P 〈 0. O1 ）. Although with higher levels in lung tumors, no statistical difference in serum levels of CEA, CA153 and CA19-9 was found in the four different tumor types. The expression of CYFRA21-1 in squamous cancer was higher than that in the three other type tumors （P 〈 0.05 ）. NSE expressed highest in small cell lung cancer （P 〈 0.01 ）, while CA 125 expressed highest in adenocarcinoma （P 〈 0. 01 ）. Conclusion The six tumor markers can be good indices for early diagnosis of lung cancer, and combined detection of CYFRA21-1 ＋ CA125 ＋ NSE will be better for the diagnosis and treatment for lung cancer.