联合检测血清肿瘤标志物对肺癌的诊断价值

Diagnostic value of the combined detection of serum tumor markers in patients with lung cancer

目的探讨肿瘤标志物神经特异性烯醇化酶(NSE)、细胞角蛋白(CYFRA21-1)、癌胚抗原(CEA)、糖类抗原125(CA125)对肺癌的诊断价值。方法用电化学发光法分别检测70例肺癌、50例肺良性疾病患者及50名正常人的血清NSE、CYFRA21-1、CEA、CA125的含量并进行分析。结果三组4种肿瘤标志物检测比较差异有统计学意义(P均<0.01);肺癌组患者NSE、CYFRA21-1、CEA、CA125水平高于良性肺疾病患者和健康人(P均<0.01)。血清中NSE在小细胞肺癌中水平高于其他类型肺癌(P均<0.01),CY-FRA21-1在鳞癌中水平高于其他类型肺癌(P均<0.05);单项NSE灵敏度最高为87.14%,联合检测以任一阳性时,灵敏度最高达98.57%,优于单项检测;NSE、CYFRA21-1、CEA灵敏度分别在小细胞肺癌、鳞癌、腺癌中最高。结论肿瘤标志物NSE、CYFRA21-1、CEA、CA125对肺癌的辅助诊断、鉴别诊断和分型有非常重要的临床意义。

Objective To investigate the diagnostic value of serum tumor markers neuron specific enolase （ NSE）, tokeratin 19 fragment （ CYFRA21-1 ）, carcinoembryonic antigen （ CEA ）, carbohydrate antigen （ CA125 ） in lung cancer. Methods The NSE, CYFRA21-1, CEA, CA125 contents of 70 cases of lung cancer,50 cases of benign disease and 50 cases of healthy controllers were detected by electrochemilumincscence immunoassay（ECLIA） and an- alyzed. Results In comparison of 4 tumor markers among three groups, the difference was statistically significant （ all P 〈 0. 01 ）. The average of the NSE, CYFRA21-1, CEA, CA125 of lung cancer group were higher than those of benign lung disease and healthy controllers （ all P 〈 0. 01 ）. The level of NSE in patients with small cell lung cancer was higher than those of other subtypes （ all P 〈 0. 01 ）. The level of CYFRA21-1 in patients with squamous cell carcino- ma was higher than those of other subtypes （ all P 〈 0. 05 ）. The sensitivity of NSE were most high in four tumor markers ,which was 87. 14%. The sensitivity of the combined detection of more than one of the four tumor markers were most high, which was 98. 57%, which was superior to signal assay. The sensitivity of NSE in small cell lung cancer was higher than those of other subtypes. The sensitivity of CYFRA21-1 in squamous cell carcinoma was higher than those of other subtypes. The sensitivity of CEA adenocarcinoma was higher than those of other subtypes. Conclusion Tumor markers NSE, CYFRA21-1, CEA, CA125 for lung cancer diagnosis, differential diagnosis and classification has very important clinical significance.