肺泡灌洗液中CEA、CYFR21-1、NSE联合检测对早期肺癌的诊断价值

Diagnostic value of combination detection of CEA,CYFR21-1,NSE in bronchoalveolar lavage fluid for early lung cancer

目的探讨肺泡灌洗液(BALF)中癌胚抗原(CEA)、细胞角蛋白19片段(CYFR)21-1、神经元特异性烯醇化酶(NSE)联合检测对早期肺癌的诊断价值,以及其与临床疗效的相关性。方法 69例肺癌患者纳入肺癌组,50例肺部良性疾病患者纳入肺良性疾病组。所有患者行肺泡灌洗术(BAL),采用化学发光免疫法检测BALF中CEA、CYFR21-1、NSE水平,比较2组患者及不同临床疗效肺癌患者肿瘤标志物水平的变化。结果肺癌组BALF中CEA、CYFR21-1、NSE水平明显高于肺良性疾病组,差异有统计学意义(P<0.05)。Ⅱ期肺癌患者各肿瘤标志物水平均高于Ⅰ期患者,差异有统计学意义(P<0.05);随着临床疗效的下降,CEA、CYFR21-1、NSE水平逐渐升高(P<0.05);联合检测的灵敏度和特异度分别为62.3%、82.0%,明显高于CEA、CYFR21-1、NSE任一单项的灵敏度和特异度(P<0.05)。结论早期肺癌患者BALF中CEA、CYFR21-1、NSE水平明显升高,且与肺癌病理分期密切相关,联合检测有助于提高早期肺癌检出率及指导临床疗效评估。

Objective To explore the diagnostic value of combination detection of carcino embryonic antigen（CEA）,cytokeratin 19 fragment 21-1（CYFR21-1）,neuron-specific enolase（NSE） in bronchoalveolar lavage fluid （BALY） for early lung cancer and its correlation with clinical effects. Methods 69 cases of lung cancer were included into the lung cancer group and 50 cases of benign pulmonary disease were included into the lung benign disease group. All the patients were given bronchoalveolar lavage（gAL）. The chemiluminescence immunoasss：y was adopted to detect the levels of CEA, CYFR21 1 and NSE in BALF. The changes of tumor markers levels were compared between the two groups and among different clinical curative effects in the patients with lung cancer. Results The levels of CEA,CYFR21-1 and NSE in BALF of the lung cancer group were significantly higher than those of the be nign pulmonary disease group, the difference was statistically significant（P〈0.05）. The levels of tumor markers in the stage Ⅱ of lung cancer were higher than those in the stage Ⅰ of lung cancer,the difference was statistically significant（P〈0.05）;tbe levels of CEA,CYFR21-1 and NSE in BALF were gradually increased with the decrease of clinical effect （P〈0.05）;the sensitivity and specificity of the combined detection of three tumor markers were 62.3 % and 82.0% respectively,which were significantly higher than those of any single tumor marker （P〈0.05）. Conclusion The levels of CEA,CYFR21-1 and NSE in BALF of early lung cancer patients are obviously increased, moreover which is closely correlated with the pathological stage of lung cancer, the combined detection could contribute to improve the detection rate of early lung cancer and guide the evaluation of clinical effect.