血清肿瘤标志物检测在肺癌中的临床价值

The Clinical Value of Serum Tumor Markers in Lung Cancer

目的研究肺癌患者血清癌胚抗原(carcinoembryonic antigen,CEA)、神经元特异性烯醇化酶(neuron-spe-cific enolase,NSE)、细胞角蛋白19片段(cytokeratin 19 fragments,CYFRA21-1)水平与肺癌分期、近期疗效的关系。方法5例确诊为肺癌的患者均完成4个周期化疗,化疗前后常规检查血清CEA、NSE、CYFRA21-1,评估其变化。结果 5例患者中血清肿瘤标志物表达阳性者占61.8%,其中小细胞肺癌(SCLC)为69.2%,非小细胞肺癌(NSCLC)为59.5%;血清CEA、NSE、CYFRA21-1表达阳性率:SCLC分别为30.8%、69.2%及7.7%;NSCLC分别为52.4%、14.3%及54.8%。CEA、NSE、CYFRA21-1表达阳性率SCLC广泛期高于局限期,差异有统计学意义(P<0.05);NSCLCⅢB期与Ⅳ期各组间比较,差异有统计学意义(P<0.05)。化疗后血清肿瘤标志物表达水平变化与近期疗效相关。结论血清肿瘤标志物CEA、NSE及CYFRA21-1与肺癌分期、近期疗效有关。肺癌晚期肿瘤标志物表达水平增高,化疗有效率明显下降。

Objective To study the relationship between the level of serum CEA,NSE and CYFRA21-1 and the stage and short-term curative effect of lung cancer.Methods 55 lung cancer patients completed four cycles of chemotherapy were included in the study.The serum CEA,NSE and CYFRA21-1 were routinely detected before and after chemotherapy.Results Serum tumor markers were positive in 61.8% of the 55 patients.The positive rate was 69.2%（9/13） in small cell lung cancer（SCLC） and 59.5% in non-small cell lung cancer（NSCLC）.In SCLC and NSCLC,the serum CEA,NSE and CYFRA21-1 expression rate were 30.8%（4/13） and 52.4%（22/42）;69.2%（9/13） and 14.3%（6/42）;7.7%（1/13） and 54.8%（23/42）,respectively.The positive rate of the tumor markers was significantly higher in SCLC with extensive stage disease than in patients with limited stage disease.In NSCLC,patients with ⅢB disease had significantly higher levels of tumors than patients with stage Ⅳ disease.After chemotherapy,the expression level of serum tumor markers changed.And the changes were related to short-term curative effect.Conclusion Serum tumor markers CEA,NSE and CYFRA21-1 are related to lung cancer stage and the short-term curative effect.