血清CA125、NSE、CT在肺癌诊断和外科治疗预后中的价值

Diagnostic and prognostic values of serum CA125, NSE, CT levels in patients with lung cancer

目的 探讨手术前肺癌患者血清中糖链抗原 12 5 (CA12 5 )、神经元特异性烯醇化酶 (NSE)、降钙素 (CT)水平在肺癌诊断及预后中的意义。方法 92例肺癌患者进入该观察 ,其中Ⅰ期 4例 ,Ⅱ期 2 1例 ,Ⅲ期5 0例 ,Ⅳ期 6例。所有患者均在手术治疗前抽血测定CA12 5、NSE、CT。同期 3 0名健康体检者被选作对照组。结果 CA12 5、NSE、CT对肺癌诊断的敏感度分别为 48.9%、2 1.7%、7.6%。CA12 5在各组肺癌血清中的测定值均显著高于健康体检者 (P <0 .0 5 ) ;NSE仅在小细胞肺癌组中高于健康体检者 (P <0 .0 1) ;CT在各组中与健康体检者无显著性差异。CA12 5正常组的术后 3年生存率为 66.0 % ( 3 1/4 7) ,CA12 5升高组为44 .4% ( 2 0 /4 5 ) ,两者有显著性差异 (P <0 .0 5 )。血清NSE、CT升高组的术后 3年生存率分别为 45 .0 % ( 9/2 0 )、42 .8% ( 3 /7) ,血清NSE、CT正常组分别为 5 8.3 % ( 4 2 /72 )、5 6.5 % ( 4 8/85 ) ,二者相比无显著性差异 (P >0 .0 5 )。结论 CA12 5、NSE、CT对肺癌的诊断价值有限 ;术前CA12

Objective To explore the clinical and prognostic values of serum carbohydrate antigen (CA125), neuron specific enolase (NSE), calcitonin (CT) levels in patients with lung cancer before operation. Methods Ninety two untreated patients with lung cancer confirmed histologically were studied. Serum CA125, NSE, and CT were detected in 92 lung cancer patients by ELISA before operation. Thirty healthy volunteers were chosen as controls. Results The sensitivity of CA125, NSE, and CT for the diagnosis of lung cancer were 48.9%, 21.7%, and 7.6% respectively. The level of CA125 in lung cancer patients was significantly higher than that of control (P<0.05). The level of NSE in patients with small cell lung cancer was significantly higher than that of control (P<0.01). The level of CT in lung cancer patients was higher than that of control, but without significant difference. The 3 year survival rate of patients with increased serum CA125 level before operation was 44.4% (20/45), whereas that of patients with normal CA125 level was 66.0% (31/47) (P<0.05). The 3 year survival rate of patients with increased serum NSE and CT levels was 45.0% (9/20) and 42.8% (3/7) respectively, whereas that of patients with normal serum NSE and CT level was 58.3% (42/72) and 56.5% (48/85) respectively. The 3 year survival rate of patients with increased serum NSE or CT level had no significant difference with that of patients with normal level (P>0.05). Conclusion The diagnostic values of CA125, NSE and CT are limited. CA125 can be used as an prognostic parameter in patients with lung cancer after operation.