不同病理类型肺癌患者血清肿瘤标志物CYFRA21-1、NSE和CEA水平的比较

Comparison of Serum CYFRA21-1,NSE and CEA,Levels in Patients with Different Pathological Types of Lung Cancer

目的:探讨联合检测肿瘤标志物CYFRA21-1、NSE和CEA在肺腺癌、肺鳞癌及小细胞肺癌的诊断性价值。方法:采用化学发光法对45例肺腺癌、42例肺鳞癌及43例小细胞肺癌患者血清中的CYFRA21-1、NSE和CEA进行检测。结果:在肺癌患者的CYFRA21-1检测中,肺鳞癌组的含量最高,肺腺癌组次之,小细胞肺癌患者最低,三组比较差异有统计学意义(F=5.842,P<0.05),而CYFRA21-1的检测水平则与肺癌TNM分期无明显相关性(P>0.05)。在肺癌患者的NSE检测中,小细胞肺癌组的含量最高,为(18.76±12.31)ng/ml(P<0.01),而肺腺癌和肺鳞癌的含量则无明显差别(P>0.05),且NSE在肺癌Ⅰ/Ⅱ期的含量明显高于Ⅲ/Ⅳ期(P<0.05)。在肺癌患者的CEA检测中,肺腺癌的含量高达(89.45±34.58)ng/ml,显著高于肺鳞癌组和小细胞肺癌组(P<0.01),且CEA在肺癌Ⅲ/Ⅳ期的含量明显高于Ⅰ/Ⅱ期(P<0.05)。三项联合检测与其他单项检测及两项联合检测相比,特异性下降幅度不明显(P>0.05),而敏感度和准确性进一步分别提升至80.00%和81.97%,差异有统计学意义(P<0.05)。结论:联合检测肿瘤标志物CYFRA21-1、NSE和CEA可提高检测肺癌的敏感度和准确度,同时为无法进行病理检查肺癌患者的诊断、分型、分期提供可靠的参考依据。

Objective： To discuss the value of combined detection of serum CYFRA21-1,NSE and CEA for the diagnosis of different pathological types of lung cancer. Methods： Serum CYFRA21-1, NSE and CEA were measured by chemiluminescence in 45 cases of lung adenocarcinoma, 42 cases of lung squamous carcinoma and 43 cases of small cell lung cancer. Results： In CYFRA21-1 detec- tion, the group of lung squamous carcinoma had the highest level, the lung adenocarcinoma group was the second, the lowest was in the small cell lung cancer group, and there is statistical differ- ence among the three groups （F=5. 842, P〈0.05）, While the detection level of CYFRA21-1 had no obvious correlation with lung cancer TNM staging （P〉0.05）. In NSE detection, small cell lung cancer group had the highest NSE content, which was （18.76±12.31）ng/ml （P〈0.01）,while there was no significant difference in NSE content bewteen lung adenocarcinoma and lung squamous carcinoma （P〉0.05）. The NSE content in patients with Ⅰ/Ⅱ staging lung cancer was significantly higher than that in patients with Ⅲ/Igstaging lung cancer（P〈0.05）. In CEA detec- tion, the CEA content in lung adenocarcinoma group was（89.45±34.58）ng/ml, which was sig- nificantly higher than that in lung squamous carcinoma group and small cell lung cancer group （P 〈0.01）. The CEA content in patients with Ⅲ/Ⅳ staging lung cancer was significantly higher than that in patients with Ⅰ/Ⅱ staging lung cancer（P〈0.05）. Compared with single detection and two joint detection, there was no obvious specificity decline in three joint detection （P〉 0.05）, and the sensitivity and accuracy increased to 80.00% and 81, 97% respectively, the differ- ence is statistically significant （P〈0.05）. Conclusion. The combined detection of tumor markers CYFRA21-1, NSE, and CEA can improve the detection sensitivity and accuracy of lung cancer, at the same time provide reliable reference basis for lung cancer diagnosis which can not be done by the pathological examination.