探讨肿瘤标记物CY211、NSE、CEA及CA125在肺癌诊断中的意义

Significance of CY211,NSE,CEA and CA125 in the diagnosis of lung cancer

目的探讨血清细胞角蛋白19片段(CY211)、神经元特异烯醇化酶(NSE)、癌胚抗原(CEA)及糖类抗原125(CA125)水平,对肺癌诊断、判断病理类型中的意义。方法电化学发光法检测295例肺癌患者和147例肺良性疾病及156例健康对照者血清CY211、NSE、CEA及CA125水平,并用ROC曲线评价肿瘤标记物的检测效能并进行比较分析。结果肺癌患者血清CY211、NSE、CEA及CA125水平明显高于肺良性疾病组及健康对照组,差异显著(P均<0.05),其中CY211的敏感度优于其余3项指标,差异显著(P<0.01);NSE在SCLC中敏感度最高,而腺癌组血清CEA水平高于鳞癌及小细胞癌组,差异显著(P<0.01)。结论血清CY211、NSE、CEA及CA125均可作为肺癌筛查的指标,取特异性90%时,CY211(>3.1 ng/mL)的敏感度最高(51.9%);NSE及CEA升高分别有助于小细胞癌及腺癌诊断;CA125对肿瘤病理类型的判断意义不大。

Objective To investigate the significance of tumor markers including cytokeratin 19 fragment（CY211）,neuron-specific enolase（NSE）,carcinoembryonic antigen（CEA）,and cancer antigen-125（CA-125） in diagnosis and histological differentiation of lung cancer.Methods Serum levels of CY211,NSE,CEA and CA125 were detected by using ECL in 295 patients with lung cancer,156 patients with benign pulmonary disease and 147 normal healthy people.Diagnostic values of these tumor markers were analyzed by receiver operative characteristic（ROC） curve.Results All serum levels of toumor markers in the patients with lung cancer were significanfly higher than those in benign pulmonary disease and healthy group（P〈0.05）.CY211 had higher sensitivity than NSE,CEA and CA125（P=0.024,0.001,and 0.001）.NSE had the highest sensitivity in SCLC and serum levels of CEA in adenocarcinomas were higher than those of squamous tumors（P=0.002） and SCLC（P=0.017）.Conclusions CY211,NSE,CEA and CA125 are all useful in lung cancer screening while CY211 has the highest sensitivity.When specifity is set to 90% and the cutoff is set to 3.1 ng/mL,the sensitivity of CY211 gets 51.9%.Increased NSE and CEA concentrations are helpful in SCLC and adenocarcinomas diagnosis respectively.CA125 has little significance in differentiating tumor histology.