血清细胞角蛋白19片段联合癌胚抗原检测对非小细胞肺癌诊断的临床价值

Clinical value of serum cytokeratin 19 fragements （CYFRA21-1） and serum tumor marker carcinoembryonic antigen （CEA） in the diagnosis of non-small cell lung cancer （NSCLC）

目的联合检测细胞角蛋白19片段（CYFRA21-1）、癌胚抗原（CEA）的血清肿瘤标志物（TM）对非小细胞肺癌（NSCLC）诊断的临床价值。方法选取2014年5月至2016年12月期间多家合作医院收治的NSCLC患者（均经病理证实，为首次确诊病例）63例设为观察组，其中观察组分为鳞癌、腺癌组；排除非小细胞肺癌，其他肺部疾病患者37例设为对照A组；正常健康体检者33名设为对照B组；分别检测观察组并根据肿瘤分期系统（TNM）不同分期的NSCLC患者及对照A组、对照B组患者的血清CYFRA21-1和CEA水平。结果血清CYFRA21-1、CEA与肿瘤组织学类型相关，肺腺癌组CEA水平显著高于肺鳞癌组（P〈0．05），肺鳞癌组CYFRA21-1水平显著高于肺腺癌组（P〈0．05）；临床分期中表达水平存在明显差异，并且结果显示为Ⅳ期〉Ⅲ期〉Ⅱ期〉Ⅰ期，差异有统计学意义（P〈0．05）；CYFRA21-1、CEA联合检测的敏感度及准确度均显著地高于单一检测。结论血清CYFRA21-1、CEA水平与NSCLC组织学类型及临床分期存在关联，CEA在肺腺癌中水平较高，而CYFRA21-1在肺鳞癌中水平较高。肿瘤临床分期越晚，TM水平越高，TM单一检测敏感度低，血清CYFRA21-1、CEA联合检测能够有效地提高敏感度、正确率。

Objective To evaluate the clinical value of cytokeratin 19 fragements （CYFRA21-1） and serum tumor marker （TM） carcinoembryonic antigen （CEA） in the diagnosis of non-small cell lung cancer （NSCLC）. Methods 63 patients with NSCLC （including squamous cell carcinoma and adenocarcinoma） were selected from May 2014 to December 2016 as observation group, 37 patients with benign lung lesions as control group A, and 33 healthy subjects as control group B. The observation group was subdivided according to the TNM stage. Serum CYFRA21-1 and CEA levels in each group were observed. Results Serum levels of CYFRA21-1 and CEA were correlated with histological type, the level of CEA in lung adenocarcinoma group was significantly higher than that in lung squamous cell carcinoma group （P〈0.05）, and the level of CYFRA21-1 in lung squamous cell carcinoma group was significantly higher than that in lung adenocarcinoma group （P〈0.05）. There was statistically significant difference in the expression level among patients with different clinical stage, and the results showed stage IV 〉 stage III 〉 stage II 〉 stage I （P〈0.05）. The sensitivity and accuracy of CYFRA21-1, CEA combined detection were significantly higher than those of single detection. Conclusions Serum levels of CYFRA21-1 and CEA are associated with histological type and clinical stage of NSCLC. The level of CEA is higher in lung adenocarcinoma, while the level of CYFRA21-1 is higher in lung squamous cell carcinoma. The more advanced the clinical stage is, the higher the level of TM is. The sensitivity of single TM detection is low, and the combined detection of serum CYFRA21-1 and CEA can improve the sensitivity and accuracy.