五种血清肿瘤标志物检测在肺癌临床诊断中的意义

Clinical diagnostic value of the detection of five kinds of serum tumor markers in lung cancer

目的探讨五种血清肿瘤标志物癌胚抗原(CEA)、糖类抗原125(CA125)、神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段(CYFRA21-1)及鳞状细胞癌相关抗原(SCC)检测对肺癌临床诊断的价值。方法采用电化学发光法检测血清中CEA、CA125、NSE、CYFRA21-1及化学发光法检测SCC的水平,比较分析五种血清学肿瘤标志物在肺癌临床诊断中的价值。结果试验中5种肿瘤标志物均能很好的鉴别肺癌患者与健康人群;CA125在诊断肺癌与其它肿瘤显著(AUC=0.706,P<0.05);SCC在诊断鳞癌显著χ2=6.963,P<0.05;CYFRA21-1在诊断小细胞肺癌与非小细胞肺癌显著χ2=9.367,P<0.05,反而NSE不显著χ2=2.279,P>0.05。CEA尽管在鳞癌比较高,但对比其它肿瘤没有显著优势;联合5种标志物检测肺癌敏感性高,尤其对鳞癌达到100%。结论 CA125在诊断肺癌与其它肿瘤及健康人群均有显著优势,SCC能较好的诊断鳞癌,CYFRA21-1在诊断小细胞肺癌与非小细胞肺癌显著优势,5种联合使用可显著提高肺癌检出敏感性。

Objective To explore the clinical diagnostic value and significance of five kinds of serum tumor markers including carcinoembryonic antigen（CEA）,carbohydrate antigen 125（CA125）,neuron-specific enolase（NSE）,cytokeratin 19fragment（CYFRA21-1）,squamous cell carcinoma antigen（SCC）for lung cancer.Methods 60 patients diagnosed first as lung cancer and 60 patients with other tumor disease at the same period were enrolled in this study.The levels of serum CEA,CA125,NSE,CYFRA21-1were detected by chemiluminescence assay,The levels of serum SCC were detected by Eletro-chemiluminescence assay.The clinical values of the 5kinds of serum tumor markers for lung cancer diagnosis were compared and analyzed.Results The levels of five kinds of tumor markers in lung cancer patients were significantly higher than those in healthy people（all AUC〉0.700）.CA125 in the diagnosis of lung cancer and other tumors significantly（AUC=0.706,P〈0.05）;SCC in the diagnosis of squamous cell carcinoma was significantlyχ2=6.963,P〈0.05;CYFRA21-1in the diagnosis of small cell lung cancer and non-small cell lung cancer significantlyχ2=9.367,P〈0.05,instead of NSE no significantχ2=2.279,P〉0.05.Conclusion CA125 in the diagnosis of lung cancer with other tumor groups or healthy people have significant advantages,SCC diagnosis of squamous cell carcinoma can be better,The significant advantage of CYFRA21-1in the diagnosis ofsmall cell lung cancer and non-small cell lung cancer.