血清肿瘤标志物AFP、CYFRA21-1、NSE对肺癌的诊断及预后价值研究

The value of serum tumor markers AFP,CYFRA21-1 and NSE in the diagnosis and prognosis of lung cancer

目的通过检测血清甲胎蛋白(AFP)、角蛋白抗原21-1(CYFRA21-1)、神经元特异性烯醇化酶(NSE)3项肿瘤标志物,分析3者在原发性肺癌患者的诊断及预后中的应用价值。方法选择2014年6月至2016年6月该院收治的89例原发性肺癌患者纳入原发性肺癌组。另外59例良性肺疾病患者纳入良性肺疾病组,63例健康体检者纳入对照组。采用电化学发光分析法检测研究对象的AFP、CYFRA21-1、NSE水平。结果治疗前,良性肺疾病组和原发性肺癌组患者的AFP、CYFRA21-1、NSE水平明显高于对照组;原发性肺癌组明显高于良性肺疾病组,差异有统计学意义(P<0.05)。Ⅲ_a期、Ⅲ_b~Ⅳ期肺癌患者的AFP、CYFRA21-1、NSE水平明显高于Ⅰ~Ⅱ期患者;Ⅲ_b~Ⅳ期患者明显高于Ⅲ_a期患者,差异有统计学意义(P<0.05)。从灵敏度、特异度、准确度分析,2项指标联合检测明显高于单项指标检测;3项指标联合检测明显高于单项指标检测及2项指标联合检测,差异有统计学意义(P<0.05)。无效组患者的AFP、CYFRA21-1、NSE明显高于有效组AFP、CYFRA21-1、NSE,差异有统计学意义(P<0.05)。结论肿瘤标志物AFP、CYFRA21-1、NSE在肺癌的诊治中有重要的价值,联合检测能提高诊断的准确度。

Objective To analyse the value of serum alpha fetoprotein(AFP),keratin antigen 21-1(CYFRA21-1)and neuron specific enolase(NSE)in the diagnosis and prognosis of lung cancer.Methods A total of 89 patients with primary lung cancer were selected as the primary lung cancer group from June 2014 to June 2016.The other 59 cases of benign lung disease were selected as the benign lung disease group,and 63 cases of healthy physical examination were collected as normal group.The content of AFP,CYFRA21-1 and NSE were detected by electrochemiluminescence assay.Results Before treatment,the levels of AFP,CYFRA21-1 and NSE in the benign lung disease group and the primary lung cancer group were significantly higher than those in the normal group,those in the primary lung cancer group were significantly higher than those in the benign lung disease group(P<0.05).The levels of AFP,CYFRA21-1 and NSE in patients with stageⅢa andⅢb-Ⅳwere significantly higher than those in patients with stageⅠ-Ⅱ,and those inⅢb-Ⅳstage were significantly higher than those inⅢa stage(P<0.05).The sensitivity,specificity,accuracy of two joint tests were significantly higher than those of the single test,those of the three joint tests were significantly higher than those of the single test and the two combined tests,and the differences were statistically significant(P<0.05).The AFP,CYFRA21-1 and NSE of the patients in the ineffective group were significantly higher than those in the effective group,and the differences were statistically significant(P<0.05).Conclusion Tumor markers AFP,YFRA21-1 and NSE are of great value in the diagnosis and treatment of lung cancer,joint detection could improve the positive rate and accuracy of diagnosis.