老年肺癌患者血清CEA、NSE、CYFRA21-1检测的临床意义

Clinical significance of CEA,NSE,CYFRA21-1 detected in senile patients with lung cancer

目的探讨血清癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、细胞角蛋白(CYFRA21-1)检测在老年肺癌辅助诊断中的临床意义。方法测定455例肺癌、382例肺部良性疾病患者的三项指标,并分析其在不同年龄组、不同病理类型、不同TNM分期的特点。结果肺癌患者血清三项指标水平明显高于肺部良性疾病患者(P<0.01),其中肺癌老年组CYFRA21-1水平高于肺癌非老年组(P<0.01)。同年龄腺癌组、鳞癌组、小细胞癌分别以血清CEA、CY-FRA21-1、NSE检测水平较高(P<0.05);CEA在腺癌老年组的表达高于腺癌非老年组,CYFRA21-1在鳞癌老年组的表达高于鳞癌非老年组,差异有统计学意义(P<0.05)。不同年龄组三项联合检测肺癌的诊断效率较单项检测显著提高(P<0.01),年龄组之间无差异。同年龄组肿瘤标志物阳性率均随着临床分期的升高而升高,Ⅳ期血清CEA、NSE阳性率明显高于Ⅰ+Ⅱ期,差异有统计学意义(P<0.05),联合检测较单项检测高,差异有统计学意义(P<0.01),CY-FRA21-1及联合检测在Ⅲ期年龄组之间差异有统计学意义(P<0.05)。结论血清肿瘤标志物CEA、NSE、CYFRA21-1的联合检测对老年肺癌患者的早期诊断、组织学分型、临床分期具有重要应用价值。

Objective To explone the clinical significance of serum CEA,NSE,CYFRA21-1 detected on auxiliary diagnosis in senile patients with lung cancer.Methods Three indexes of 455 cases lung cancer and 382 cases lung benign disease patients were detected,and observed their characteristics in different age groups,different pathological types and different TNM stages.Results The three indexes level of lung cancer patients were obviously higher than lung benign disease patients′（BLD）（P〈0.01）,in which CYFRA21-1 level of senile patients with lung cancer groups were higher than non-senile groups′（P〈0.01）.In same age group,levels of serum of CEA,CYFRA21-1,NSE adenocarcinoma,squamous carcinoma and small cell carcinoma groups tested were respectively higher;There were statistics significance on the differences of adenocarcinoma patients′s CEA and squamous carcinoma patients′s CYFRA21-1 among different age groups （P〈0.05）.Compared with each single item,diagnostic efficiency of the joint detection of three indexes of lung cancer was remarkably improved,and there was no difference among different age groups.Positive rate of tumor markers in same age group was increased along with the rise of clinical stages,positive rates of Ⅳ stage suffers′CEA and NSE were clearly higher than Ⅰ＋Ⅱ stage suffers′,there was statistics significance on the differences（P〈0.05）.Joint detection is higher than single item,the difference is prominent （P〈0.01）,among age groups,there were statistics significance on detection difference among CYFRA21-1 on Ⅲ stage and joint diagnosis（P〈0.05）.Conclusion There are important application value to have a joint detection of serum tumor markers CEA,NSE,CYFRA21-1 on early diagnosis,histology typing and clinical stages of senile patients with lung cancer.