探讨肺癌患者肿瘤标志物CYFRA21-1、CEA、CA12-5、NSE与中医辨证分型之间的相关性

Correlation Exploration between Tumor Markers CYFRA21-1,CEA,CA12-5,NSE of Lung Cancer Patients and TCM Syndrome Differentiation

目的 :探讨患者血清肿瘤标志物CYFRA21-1、CA12-5、CEA、NSE水平变化在肺癌中医辨证分型间的临床应用价值。方法 :收集2017年1月—2018年3月辽宁中医药大学附属医院研究对象342例,其中肺癌组患者242例,肺良性组患者50例,健康对照组50例,对其肺癌肿瘤标志物CYFRA21-1、CEA、CA12-5、NSE结果进行分析,比较肺癌患者中医分型和西医分型之间的相关性,观察不同中医辨证分型中4种肿瘤标志物的水平变化。结果 :肺癌患者的西医组织病理分型与中医辨证分型不相关,无统计学意义(P>0.05);CEA水平在瘀阻肺络型中最高,在气阴两虚型、阴虚毒热型、痰湿蕴肺型中依次降低,具有统计学意义(P<0.05);气阴两虚型CYFRA21-1、CA12-5水平高于其他各中医分型组(P<0.05);NSE水平在肺癌各中医辨证分型间无统计学意义(P>0.05)。结论 :肺癌肿瘤标志物CYFRA21-1、CA12-5、CEA的检测结果与中医辨证分型有一定的相关性,可作为肺癌中医辨证分型的辅助依据。

Objective:To explore the clinical application value of changes in serum tumor markers CYFRA21-1,CA12-5,CEA and NSE levels in lung cancer patients in TCM syndrome differentiation.Methods:342 patients in the first affiliated hospital of Liaoning university of triditional Chinese medicine from January 2017 to March 2018 were collected,including 242 patients with lung cancer,50 patients with benign lung diseases and 50 healthy controls.the results of tumor markers of lung cancer(CYFRA21-1,CEA,CA12-5,NSE)were analyzed,and the correlation between TCM classification of lung cancer patients and Western medicine classification was compared.The changes of four tumor markers in different TCM dialectical classification were observed.Results:Western medicine histopathological classification of lung cancer patients was not correlated with TCM dialectical classification,and had no statistical significance(P>0.05).The CEA level was the highest in the type of stasis blocking lung collaterals,and decreased progressively in the type of Qi and Yin deficiency syndrome,the type of Yin deficiency and toxic heat,and the type of phlegm-dampness accumulating lung(P<0.05).CYFRA21-1 and CA12-5 levels of Qi and Yin deficiency syndrome were higher than those of other TCM classification groups(P<0.05).NSE level was not statistically significant among different TCM syndromes of lung cancer(P>0.05).Conclusion:The detection results of CYFRA21-1,CA12-5 and CEA,tumor markers of lung cancer,have certain correlation with TCM syndrome differentiation of lung cancer and can be used as an auxiliary basis for it.