血清肿瘤标志物检测在肺癌诊断中价值

目的探讨血清中癌胚抗原（CEA）、可溶性细胞角蛋白19片段（CYFRA 21-1）、神经元特异性烯醇化酶（NSE）、鳞状细胞癌相关抗原（SCC）浓度对肺癌的诊断、病理分型及临床分期的意义。方法选择经组织学和细胞学确诊的125例肺癌患者作为观察组，125例肺部良性病变患者作为对照组，分别测定两组患者血清中CEA、CYFRA 21-1、NSE、SCC的浓度。结果（1）观察组血清中四项肿瘤标志物浓度明显高于对照组（P〈0.01）。（2）腺癌血清CEA浓度最高，鳞癌血清CYFRA 21-1、SCC浓度最高，小细胞癌（SCLC）血清NSE浓度最高（P〈0.05）。（3）血清中四项肿瘤标志物浓度随肺癌TNM临床分期越晚浓度越高（P〈0.05）。（4）联合检测诊断肺癌的敏感性和准确性明显高于单项检测（P〈0.01），联合检测特异性下降，与CEA、CYFRA 21-1对比（P〈0.01）。结论血清中CEA、CYFRA 21-1、NSE及SCC的检测在肺癌的诊断、病理分型、判断预后有较好的临床价值，值得在临床上推广应用。

Objective To investigate the serum carcinoembryonic antigen（CEA）,cytokeratin 19 fragment（CYFRA 21-1）,neuron specific enolase（NSE）,squamous cell carcinoma antigen（SCC）concentration in lung cancer diagnosis, pathological typing and clinical staging significance. Methods Select 125 cases of patients with lung cancer histology and cytology confirmed as the observation group,125 patients with benign pulmonary disease patients as control group,two groups of patients with serum CEA concentration in 21-1,CYFRA,NSE,SCC were measured. Results ①The observation group of four tumor markers in serum concentration was significantly higher than that of the control group（P〈O.01）. ②The highest serum CEA concentration of adenocarcinoma,squamous cell carcinoma,the highest concentration of serum CYFRA21-1 SCC,serum SCLC NSE concentration was highest（P〈0.05）. ③The serum levels of four tumor markers in lung cancer TNM concentration is higher in later clinical stages was higher（P〈0.05）. ④The joint detection in diagnosis of lung cancer was significantly higher than that of the sensitivity and accuracy of the single detection（P〈0.01）,the specificity of combined detection of CEA,CYFRA21-1 decreased,and the contrast（P〈0.01）. Conclusion Pathological detection of SCC and CEA,CYFRA,21-1,NSE in serum in lung cancer diagnosis,classification,prognosis has good clinical value and is worth for clinical application.