肿瘤患者与其血清标志物关系的临床意义

Clinical significance of the relationship between tumor patients and their serum markers

目的研究肿瘤患者与其血清标志物--癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、细胞角蛋白19血清片段21-1(CYFRA21-1)和糖链抗原15-3(CA15-3)关系的临床意义。方法选取经本院细胞学、病理确诊和经病理分类的79例肺癌患者,包括无转移37例和有转移患者42例;同期选取健康体检者36例作为对照。测定肺癌患者血清CEA、NSE、CYFRA21-1和CA15-3的含量,分析上述肿瘤标志物的临床意义。结果纳入患者包括:Ⅰ期肺癌7例、Ⅱ期12例、Ⅲ期18例和Ⅵ期42例;肿瘤标志物的发展伴随肺癌血清逐渐升高,且与肺癌晚期呈正相关(r=3.88,P<0.05);Ⅰ、Ⅱ期肿瘤标志物CYFRA21-1和CA15-3含量明显较Ⅲ、Ⅳ期低,两者间差异均有统计学意义(均P<0.01);未转移肺癌患者血清肿瘤标志物(CEA和CYFRA21-1)明显低于转移患者,两者间差异有统计学意义(均P<0.01);中位生存期:非小细胞肺癌和小细胞肺癌分别为6.6,13.0个月。结论联合检测明显优于单一检测,CEA、NSE、CYFRA21-1和CA15-3含量对肺癌转移和肺癌分期有临床意义。

Objective To study the clinical significance of the relationship between tumor patients and their serum markers,such as carcinoembryonic antigen(CEA),neuron-specific enolase(NSE),cytokeratin 19 serum fragment 21-1(CYFRA21-1) and carbohydrate antigen 15-3(CA15-3). Methods Seventy-nine patients with lung cancer were diagnosed by cytology and pathology in our hospital. The pathological classification was performed,including 37 patients and 42 patients with no metastasis and metastasis,respectively. In the same period,36 healthy subjects were selected as the control. The serum levels of CEA,NSE,CYFRA21-1,and CA15-3 in lung cancer patients were determined.The clinical significance of tumor markers was analyzed. Results There were 7 cases of stage Ⅰ lung cancer,12 cases of stage Ⅱ,18 cases of stage Ⅲ,and 42 cases of stage Ⅳ. The development of tumor markers was positively correlated with the increase of serum of lung can-cer and the late stage of lung cancer(r=3.88, P<0.05). The levels of stage Ⅰ and II tumor markers CYFRA21-1,and CA15-3 were significantly lower than those of stage Ⅲ and stage Ⅳ with significantly(all P<0.01). The serum tumor markers(CEA and CYFRA21-1) of no transfer lung cancer patients were significantly lower than those of transfer lung cancer with significantly( all P < 0. 01). Tumor markers in non-small cell lung cancer showed a median survival of 6. 6 months and a small cell lung cancer of 13. 00 months. Conclusion Combined detection is significantly better than single detection. CEA,NSE,CYFRA21-1,and CA15-3 content have clinical significance for lung cancer metastasis and lung cancer staging.