胸腔积液中肿瘤标志物的联合检测对肺癌的诊断价值

Diagnostic value of combined detection of tumor markers in pleural effusion in lung cancer

目的探讨胸腔积液和血清中癌胚抗原(CEA),神经元特异性烯醇化酶(NSE)和细胞角蛋白19片段(CYFRA21-1)联合检测在肺癌诊断中的临床价值。方法将127例胸腔积液患者分为两组,良性组58例,恶性组69例,分别对两组患者胸腔积液和血清中的CEA,NSE和CYFRA21-1进行测定,并对两组的测定结果进行比对分析。结果恶性组患者胸腔积液中的CEA,NSE和CYFRA21-1浓度均明显高于良性组,差异有统计学意义(t=16.3,5.9,8.5,P均<0.01);恶性组患者胸腔积液中的CEA,NSE和CYFRA21-1浓度均明显高于血清中的浓度,差异有统计学意义(t=4.91,5.23,6.11,P均<0.05);CEA,NSE和CYFRA21-1的联合检测在诊断肺癌的敏感度和特异度均明显高于单独某一项的检测,差异有统计学意义(P<0.05)。结论胸腔积液和血清中CEA,NSE和CYFRA21-1的检测对肺癌有一定的临床诊断价值,且三项肿瘤标志物联合检测能够明显提高肺癌诊断的特异度和敏感度。

Objective To explore the clinical value of the combined detection of carcinoembryonic antigen （CEA） , neuron specific enolase （NSE） and cytokeratin 19 fragment （CYFRA21-1） in pleural effusion and serum in the diagnosis of lung cancer. Methods A total of 127 patients with pleural effusion were divided into benign group （n = 58 ） and malignant group （n = 69 ）. CEA, NSE and CYFRA21-1 in pleural effusion and sera were respectively measured and compared between the two groups. Results CEA, NSE and CYFRA21-1 concentrations were significantly higher in the malignant group than in the benign group （ t = 16.3, 5.9 and 8.5 ; P 〈 0.01 ）. In the malignant group, CEA, NSE and CYFRA21-1 concentrations were significantly higher in the pleural effu- sion than in the sera （ t = 4.91, 5.23 and 6.11 ; P 〈 0.05 ）. The sensitivity and the specificity of the joint detection of CEA, NSE and CYFRA21-1 were significantly higher than that of the single detection in the diagnosis of lung cancer （ P 〈 0.05 ）. Conclusion Determinations of CEA, NSE and CYFRA21-1 in pleural effusion and serum are of certain clinical value in diagnosis of lung cancer, and the joint detection of the three markers may significantly promote its specificity and the sensitivity.