血清肿瘤标志物在肺癌诊断中的应用价值

Significance of serum tumor markers in the diagnosis of lung cancer

目的探讨血清细胞角蛋白19片段21-1(Cyfra21-1)、鳞癌抗原(SCC)、神经元特异性烯醇化酶(NSE)和血浆D-二聚体(D-D)在肺癌诊断中的应用价值。方法探讨2015年12月至2017年12月间陕西省渭南市中心医院收治的82例肺癌患者为肺癌组,58例肺部良性疾病患者为肺部良性疾病组,64例体检健康者为对照组。检测三组受试者血浆D-D以及血清Cyfra21-1、SCC和NSE水平,比较Ⅰ~Ⅱ期和Ⅲ~Ⅳ期肺癌患者的血浆D-D及血清Cyfra21-1、SCC和NSE水平。对肺癌组患者进行1年的随访,根据复发情况分为未复发组和复发组,比较两组患者的血浆D-D及血清Cyfra21-1、SCC和NSE水平。结果肺癌组患者血浆D-D以及血清Cyfra21-1、SCC和NSE水平均高于对照组和肺部良性疾病组,差异均有统计学意义(均P<0.05)。Ⅲ~Ⅳ期肺癌患者的血浆D-D以及血清Cyfra21-1、SCC和NSE水平均高于Ⅰ~Ⅱ期肺癌患者,差异均有统计学意义(均P<0.05)。肺癌组患者血浆D-D以及血清Cyfra21-1、SCC和NSE阳性率均高于对照组和肺部良性疾病组,差异均有统计学意义(均P<0.05)。复发组肺癌患者的血浆D-D以及血清Cyfra21-1、SCC和NSE水平均高于未复发组,差异均有统计学意义(均P<0.05)。结论联合检测血浆D-D以及血清Cyfra21-1、SCC和NSE对肺癌患者有较佳的临床辅助诊断价值,且有助于评估预后情况。

Objective To study the value of serum cytokeratin 19 fragment 21-1(Cyfra21-1),squamous cell carcinoma antigen(SCC),neuron specific enolase(NSE)and plasma D-dimer(D-D)in the diagnosis of lung cancer.Methods Eighty-two patients with lung cancer who were treated at Weinan Central Hospital from December 2015 to December 2017 were selected as the lung cancer group,58 patients with benign pulmonary disorder were included in the benign pulmonary tumors group,and 64 healthy persons who had physical examination were included in the control group.The levels of plasma D-D and serum Cyfra21-1,SCC and NSE were measured in lung cancer group,benign lung cancer group and control group.The levels of plasma D-D and serum Cyfra21-1,SCC and NSE were compared between patients with stage I^II lung cancer and patients with stage III^IV lung cancer.The patients with lung cancer were followed up for 1 year,and then were divided into non-recurrence group and recurrence group.The levels of plasma D-D,serum Cyfra21-1,SCC and NSE were compared between the two groups.Results The levels of plasma D-D,Cyfra21-1,SCC and NSE were significantly higher in lung cancer group than in control group and benign lung cancer group(all P<0.05).The levels of plasma D-D,Cyfra21-1,SCC and NSE were significantly higher in patients with stage III^IV lung cancer than in patients with stage I^II lung cancer(all P<0.05).The positive rates of plasma D-D,serum Cyfra21-1,SCC and NSE were significantly higher in lung cancer group than in control group and benign lung disease group(all P<0.05).The levels of plasma D-D and serum Cyfra21-1,SCC and NSE were significantly higher in the relapsed group than in the non-relapsed group(all P<0.05).Conclusion The combination detection of plasma D-D and serum Cyfra21-1,SCC and NSE has good clinical diagnostic significance for lung cancer and is helpful to predict the prognosis.