非小细胞肺癌患者血清CYFRA_(21-1)和CEA的临床应用

Clinical Measurement and Evaluation of CYFRA_(21-1) and CEA for Non Small Cell Cancer

目的 研究癌标CYFRA2 1 1及CEA对非小细胞肺癌 (NSCLC)诊断、病情及预后的临床应用价值。方法 用放射免疫法检测 10 1例NSCLC患者和 112例良性肺疾病患者血清CYFRA2 1 1和CEA ,比较NSCLC的不同组织类型、临床分期、手术前后差异。结果 CYFRA2 1 1对NSCLC诊断敏感性、特异性、有效性为 72 .4 %、87.3%、79.1% ,CYFRA2 1 1对鳞癌诊断敏感性、有效性高于腺癌 (P <0 .0 5 ) ,而CEA对NSCLC诊断敏感性、特异性、有效性为 4 7.5 %、94 .0 %、71.6 % ,CEA对腺癌诊断敏感性、有效性高于鳞癌 (P <0 .0 1) ,CYFRA2 1 1与CEA联合应用可提高对NSCLC诊断敏感性、有效性。血清CYFRA2 1 1水平与TNM分期有关 ,随病情变化而改变。结论 血清CYFRA2 1 1检测特别是与CEA联合应用对NSCLC患者诊断、病情监测、预后判断有较高临床应用价值。

Objective This study tried to investigute the effect of serum CYFRA 21 1 as a new lung cancer marker, with CEA, in clinical dignosis and monitoring the prognosis of non small cell lung cancer (NSCLC).MethodsThe serum levels of CYFRA 21 1 and CEA in 101 patients with NSCLC and 112 patients with benign lung disaeses(BLD) were measured by radioimmunoassay.Serum CYFRA 21 1 and CEA were compared between different histological types, Clinical stages; before and after operation.Results The sensitivity, specificty and diagostic accuracy rate of CYFRA 21 1 in NSCLC were 72.4%, 87.3%,79.1%. The sensitivity and diagostic accuracy rate of CYFRA 21 1 were higher in squamous cell cancer than Adenocarcinoma( P <0.05).The sensitivity,specificity and diagostic accuracy rate of CEA in NSCLC were 47.5%, 94.0%,71.6%.The sensitivity and diagnostic accuracy rate of CEA were higher in Adenocarcionoma than squamous cell cancer( P <0.01).The Sensitivity and diagostic accuracy rate was higher in combined CYFRA 21 1 and CEA than the single tumor marker. In accorndance with TNM classification of NSCLC, there were similar changes between serum level of CYFRA 21 1 and clinical classification stage. In Ⅳ stage NSCLC, serum level of CYFRA 21 1 was higher in died in one years than still alive after one years( P <0.05).Conclusion CYFRA 21 1 particulily combined with CEA, can be useful diagnostic and momitoring tumor marker of NSCLC.