血清肿瘤标志物联合检测在肺癌诊断中的临床价值

目的探讨血清癌胚抗原(CEA)、癌胚抗原125(CA125)、细胞角蛋白19片段21-1(CY-FRA21-1)和神经元特异性烯醇化酶(NSE)在肺癌患者血清中的水平及其在肺癌鉴别诊断中的价值。方法采用化学发光微粒子免疫分析法检测CEA和CA125,采用免疫发光夹心法测定CYFRA21-1和NSE,比较分析68例肺癌患者、30例肺部感染患者和32例健康者此4项肿瘤标志物水平。结果肺癌患者的4种血清肿瘤标志物水平均明显高于良性疾病组和正常对照组,差异均有统计学意义(P<0.05);CEA及CA125在腺癌中表达显著高于鳞状细胞癌和小细胞肺癌(P<0.05);鳞状细胞癌及腺癌中CYFRA21-1水平明显高于小细胞肺癌(P<0.05);NSE在小细胞肺癌中呈高表达,明显高于鳞癌与腺癌(P<0.05);单项检测CEA、CA125、CYFRA21-1和NSE对肺癌的敏感度分别为45.5%、60.1%、48.5%和48.5%,4项联合检测的敏感度为88.9%。结论 4项肿瘤标志物对肺癌的检测都有一定意义,可为肺癌的鉴别诊断提供依据,联合检测可提高肺癌诊断的灵敏度和准确度。

Clinical Value of Combined Detection with Serum Tumor Markers in Diagnosis of Lung Cancer

Objective To explore the serum levels of carcino-embryonic antigen(CEA),cancer antigen 125(CA125),cytokeratin 19 fragment 21-1(CYFRA21-1),neuronspecific enolase(NSE)in patients with lung cancer,and their value in differential diagnosis of lung cancer.Methods Serum CEA,CEA125(with microparticle chemiluminescence immunoassay)and CYFRA21-1,NSE(with fluoroimmunoassay)levels were detected in 68 patients with lung cancer,30 patients with pulmonary infection and 32 healthy people.Results 4 serum tumor markers in patients with lung cancer were significant higher than those in benign disease and normal control group(P<0.05).CEA and CA125 levels in adenocarcinoma were significant higher than those in squamous cell cancer and small cell cancer(P<0.05).CYFRA21-1 levels in adenocarcinoma and squamous cell cancer were significant higher than that in small cell cancer(P<0.05).NSE level small cell cancer was significant higher than that in adenocarcinoma and squamous cell cancer(P<0.05).The sensitivity of CEA,CEA125,CYFRA21-1,and NSE was 45.5%,60.1%,48.5%,and 48.5% respectively,and the sensitivity of 4 markers was 88.9% in lung cancer.Conclusion CEA,CEA125,CYFRA21-1,NSE levels have significance in detection of lung cancer,which provide evidence for differential diagnosis of lung cancer.Combined detection with 4 tumor markers can improve sensitivity and accuracy in diagnosis of lung cancer.