胸腔积液CYFRA21-1、NSE和CEA联合检测在肺癌分型及临床分期中的临床意义

Clinical Significance of Combined Detection of CYFRA21-1,NSE and CEA in Classification and Staging of Patients with Lung Cancer

探讨胸腔积液中CYFRA21-1(细胞角蛋白19片段)、NSE和CEA的检测在肺癌分型及临床分期中的意义。采用电化学发光法检测330例肺癌患者胸腔积液和43例良性胸积液中的CYFRA21-1、NSE和CEA水平。结果显示,肺癌组胸腔积液的CYFRA21-1、NSE和CEA水平明显高于良性胸积液组(P<0.01)。不同病理类型肺癌的标志物阳性率各不相同,鳞癌组CYFRA21-1阳性率最高,为65.5%;腺癌组CEA阳性率最高,为65.0%;小细胞未分化癌组NSE阳性率最高,为79.5%,三项联合检测阳性率高于单项检测;标志物水平与临床分期呈正相关,临床分期越晚,标志物水平越高,Ⅲ～Ⅳ期明显高于Ⅰ～Ⅱ期(P<0.05)。结论:CYFRA21-1、NSE和CEA联合检测能提高肺癌检测阳性率,并对肺癌的分型及临床分期有临床意义。

To explore clinical value of combined detection of CYFRA21-1,NSE and CEA in classification and staging of patients with lung cancer,the CYFRA21-1,NSE and CEA levels in pleural effusion in 330 patients with lung cancer and in 43 patients with benign were detected by the electrochemiluminescence.The results showed that CYFRA21-1,NSE and CEA levels in pleural effusion in patients with lung cancer group were significantly higher than that of in benign group（P〈0.01）.The positive rate of tumor markers in different pathological type lung cancer were different,which CYFRA21-1 positive rate in squamous cell cancer group was highest with 65.5%;CEA positive rate in glands cancer group was supreme with 65.0%;the NSE positive rate in differentiation cancer group was highest with 79.5%.The positive rate in three markers combined detection was higher than that in one item detection.The tumor marker levels in lung cancer were positively related with clinical staging.The higher of tumor marker levels and the more late of clinical staging,and the clinical Ⅲ-Ⅳ period was obviously higher than thatⅠ-Ⅱ period（P〈0.05）.The combined detection of CYFRA21-1,NSE and CEA may enhance the positive rate in lung cancer detection,and may have significant clinical value in the classification and staging of patients with lung cancer.