五种血清肿瘤标志物联合检测对肺癌的临床诊断价值

Clinical diagnostic value of combined detection of five kinds of serum tumor markers for lung cancer

目的探讨五种血清肿瘤标志物癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)、神经元特异性烯醇化酶(NSE)、糖类抗原125(CA125)和糖类抗原242(CA242)联合检测对肺癌临床诊断的价值和意义。方法选择57例初诊肺癌患者作为实验组,选择同期55例良性肺疾病患者作为对照组。采用化学发光法(CLIA)检测血清肿瘤标志物CEA、CYFRA21-1、NSE、CA125和CA242的水平,比较分析五种血清肿瘤标志物检测在肺癌临床诊断中的价值。结果实验组五种肿瘤标志物的水平均明显高于对照组(P均<0.05);且五种血清肿瘤标志物在不同病理类型肺癌中有不同水平,CEA、CA125、CA242在腺癌中表达较高,而CYFRA21-1在鳞癌中表达较高,NSE在小细胞癌中表达较高;联合检测时对诊断的灵敏度和准确率分别为92.8%和89.6%,明显高于各单项检查(P均<0.05)。结论血清肿瘤标志物CEA、CYFRA21-1、NSE、CA125和CA242联合检测可以提高肺癌诊断的灵敏度和准确率,可应用于肺癌的生物学诊断。

Objective To explore the clinical diagnostic value and significance of combined detecting five kinds of serum tumor markers including carcinoembryonic antigen （CEA） ,eytokeratin 19 fragment （CYFRA21-1） , neuron-specific enolase （ NSE）, carbohydrate antigen 125 （ CA125 ）, carbohydrate antigen 242 （ CA242 ） for lung cancer. Methods Fifty-seven patients diagnosed first as lung cancer （experimental group） and 55 patients with benign lung disease （control group ） at the same period were enrolled in this study. The levels of serum CEA, CYFRA21-1 ,NSE,CA125 and CA242 were detected by chemiluminescence assay （CLIA）. The clinical values of the 5 kinds of serum tumor markers for lung cancer diagnosis were compared and analyzed. Results The levels of five kinds of tumor markers in experimental group were significantly higher than those in control group （ all P 〈 0.05 ）. The serum tumor markers had different expression levels in various pathological types of lung cancer：CEA, CA125 and CA242 showed higher expression in adenocareinoma; CYFRA21-1 showed higher expression in squamous cell carcinoma; NSE showed higher expression in small cell carcinoma. The sensitivity and accuracy of combined detection were 92.8% and 89.6% ,respectively,which were significantly higher than each individual events （ all P 〈0. 05）. Conclusions Combined detecting CEA, CYFRA21-1, NSE , CA125 and CA242 can improve the sensitivity and accuracy for the diagnosis of lung cancer, and it can be used in the biological diagnosis of lung cancer.