CYFRA21-1、CA19-9、VEGF联合检测对非小细胞肺癌临床诊断价值的探讨

目的探讨血清肿瘤标志物细胞角蛋白19片段(CYFRA21-1)、肿瘤相关糖链抗原19-9(CA19-9)、血管内皮生长因子(VEGF)联合检测在非小细胞肺癌中的诊断价值,及其水平与NSCLC病理类型和临床分期的关系。方法应用酶联免疫吸附(ELISA)双抗体夹心法对52例NSCLC患者、30例肺良性病变患者和16例健康体检者血清中CYFRA21-1、CA19-9、VEGF的水平进行检测。结果 NSCLC患者血清CYFRA21-1、CA19-9、VEGF含量均明显高于肺良性病变组和健康对照组(P<0.05)。III～IV期NSCLC患者血中CYFRA21-1、CA19-9、VEGF水平明显高于I～II期患者(P<0.05)。肺鳞癌组CYFRA21-1水平显著高于腺癌组(P<0.05),肺腺癌组CA19-9水平显著高于鳞癌组(P<0.05),VEGF在肺腺癌组水平与肺鳞癌组差别无显著性(P>0.05)。血清中CYFRA21-1、CA19-9、VEGF平行试验联合检测非小细胞肺癌的灵敏度为94.23%,显著高于单项检测(P<0.05);特异度为43.48%,与单项检测相比有所下降(P>0.05)。结论联合检测CYFRA21-1、CA19-9、VEGF在非小细胞肺癌的辅助诊断中有重要的临床应用价值,能提高检测的检出灵敏度。肺癌临床分期越晚,CYFRA21-1、CA19-9、VEGF含量越高。血清CYFRA21-1、CA19-9水平检测对鉴别肺腺癌和肺鳞癌有一定意义,而VEGF水平检测对鉴别肺腺癌和肺鳞癌无意义。

Objective This study evaluated the diagnostic value of combined measurement of CYFRA21-1,CA19-9 and VEGF in non-small cell lung cancer（NSCLC）,and their relationships in two pathological types and different clinical stages of lung cancer by detecting CYFRA21-1、CA19-9 and VEGF level changes of serum in patients with NSCLC.Methods 52 newly-diagnosed inpatients with NSCLC,30 patients with benign lung diseases and 16 healthy adults served as the control groups.The level of CYFRA21-1、CA19-9 and VEGF in serum were determined by enzyme-linked immunosorbent assay（ELISA）.Results The serum levels of CYFRA21-1、CA19-9 and VEGF in patients with NSCLC were significantly higher than the two control groups（P0.05）.The serum levels of CYFRA21-1、CA19-9 and VEGF in patients with stage III-IV NSCLC were significantly higher than those with stage I-II（P0.05）.The serum level of CYFRA21-1 in patients with squamous cell carcinoma was significantly higher than those with adenocarcinoma（P0.05）,whereas the serum level of CA19-9 with adenocarcinoma was significantly higher than those with squamous cell carcinoma（P0.05）.No significant difference was found between adenocarcinoma and squamous cell carcinoma in serum VEGF level（P0.05）.The sensitivity of combined measurement in the serum level of CYFRA21-1、CA19-9 and VEGF were 94.23%,which were significantly higher than those of the single test（P0.05）,but the specificity of combined measurement for the serum level of these three tumor markers were 43.48%,which were lower than those of the single test.Conclusion There are significant clinical application value in the auxiliary diagnosis of lung cancer in NSCLC by combined measurement CYFRA21-1、CA19-9 and VEGF,because the combined measurement can improve the positive rate.The serum levels of CYFRA21-1、CA19-9 and VEGF are higher in advanced stage of NSCLC than in early stage.The serum levels of CYFRA21-1 and CA19-9 have significance in differential diagnosis between adenocarcinoma and squamous cell carcinoma,whereas the serum levels of VEGF have no significance in differential diagnosis between these two types of carcinomas.