CEA、NSE、CYFRA21-1联合检测对肺癌的早期诊断价值

Early Diagnosis value of Serum CEA,NSE and CYFRA21-1 Combine Detection on Lung Cancer

目的探讨癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段21-1(CYFRA21-1)联合检测对肺癌的早期诊断价值。方法选择2012年7月至2014年7月重庆市巴南区人民医院收治的148例肺部病变患者作为研究对象,所有患者均于CT引导下经皮经肺穿刺活检,并检测患者血清CEA、NSE、CYFRA21-1肿瘤标志物水平。结果 148例患者均成功穿刺,经病理组织学检测确诊为肺癌125例,良性肿瘤23例;肺癌组血清CEA[(78.5±9.4)μg/L]、NSE[(22.9±3.2)μg/L]、CYFRA21-1[(15.2±1.5)μg/L]水平均显著高于良性组[(14.9±1.3)μg/L、(10.4±1.6)μg/L、(2.9±0.2)μg/L],差异有统计学意义(均P<0.01)。小细胞肺癌组27例血清NSE水平显著高于非小细胞肺癌组98例[(43.2±7.3)μg/L比(17.3±1.6)μg/L],差异有统计学意义(P<0.01)。以穿刺活检诊断为金标准,三项指标联合检测能够提高灵敏度(79.2%,99/125)、准确度(75.7%,112/148)和阳性预测值(90.8%,99/109)。结论血清CEA、NSE、CYFRA21-1联合检测能够作为肺癌的辅助诊断方法之一。

Objective To explore the early diagnosis value of combined detection ofserum careinoem- bryonic antigen（CEA） ,neuron-specific enolase（NSE） and cytokeratin fragment atigen 21-1 （ CYFRA21-1 ） on lung cancer. Methods A total of 148 cases of lung disease treated in Banan People＇s Hospital from Jul. 2012 to Jul. 2014 were included as research objects. All patients underwent pereutaneous puncture biopsy under CT guidance, and serum levels of NSE, CEA and CYFRA21-1 tumor markers were detected. Results All of the 148 cases were successfully punctured, 125 cases were diagnosed as lung cancer by pathological examination,23 cases were benign tumor. The levels of serum CEA [ （78.5 ±9. 4） μg/L] ,NSE [ （22.9 ± 3.2） μg/L] and CYFRA21-1 [ （ 15.2 ±1.5 ） μg/L] in the lung cancer group were significantly higher than the benign group [ （ 14.9 ± 1.3 ） μg/L, （ 10. 4 ± 1.6） μg/L, （2. 9 ± 0. 2 ）μg/L], and the differences were statistically significant（ P 〈 0. 01 ）. The serum NSE level of the small cell lung cancer group was signifi- cantly higher than the non-small cell lung cancer[ （43.2 ±7.3 ） μg/L vs （ 17.3 ± 1.6 ） μg/L] （ P 〈 0.01 ）. With biopsy diagnosis as ＂Gold standard＂. The combined detection of the three indexes improved the sensitivity （79.2% ,99/125） ,accuracy （75.7% ,112/148） and the positive predictive value （90. 8% ,99/ 109）. Conclusion Serum CEA, NSE and CYFRA21-1 combined test can be used as one of the assistant diagnostic methods for lung cancer.