血清NSE、ProGRP、CEA、SCCA和CYFRA21-1联检在肺癌诊断中的意义

目的:探讨胃泌素释放肽前体(progastrin-releasing peptide,ProGRP)、神经特异性烯醇化酶(neuronspecific enolase,NSE)、癌胚抗原(carcino-embryonic antigen,CEA)、鳞状细胞癌抗原(squamous cell carcinomaantigen,SCCA)及细胞角蛋白19(CYFRA21-1)在肺癌诊断中的价值和临床意义。方法:分别采用化学发光法或电化学发光法检测14例肺部良性疾病、12例小细胞肺癌、29例非小细胞肺癌患者血清ProGRP、NSE、CEA、SCCA、CYFRA21-1含量。结果:NSE、ProGRP对SCLC诊断的敏感性分别为66.7%、83.3%,且NSE与ProGRP具有很好的相关性,CYFRA21-1对鳞癌诊断的敏感性为63.6%,CEA对腺癌诊断的敏感性为64.3%。SCLC组ProGRP、NSE水平均显著高于NSCLC组、肺良性疾病组,差异有统计学意义。NSCLC组,CYFRA21-1水平显著高于其余两组,差异有统计学意义。ProGRP、NSE联检对SCLC的检出率可达91.7%,CYFRA21-1、SCCA、CEA联检对腺癌、鳞癌的检出率分别为71.4%、72.7%。结论:ProGRP及ProGRP+NSE是SCLC诊断的较好指标,CYFRA21-1、CEA分别对鳞癌、腺癌具有一定的诊断价值。

Diagnostic Significance of Combined Deteceion on Serum ProGRP, NSE,CEA, SCCA and CYFRA21 -1 in Patients with Lung Cancer

Objective To study the value of serum progastrin-releasing peptide （ ProGRP）, neuron specific enolase （ NSE）, carcino-embryonic antigen（CEA）, squamous cell carcinoma antigen （SCCA） and cell keratin 19 segment （CYFRA21-1） in lung cancer diagnosis. Methods The serum levels of ProGRP, NSE, CEA, SCCA and CYFRA21-1 were detected in 14 patients with benign lung diseases, 12 patients with small cell lung cancer （SCLC） and 29 patients with non- small cell lung cancer （NSCLC） by using chemiluminescence immunoassay（CLIA） or electrochemiluminescence immunoassay （ECLIA） respectively. Results The sensitivity of ProGRP, NSE for diagnosing SCLC were 66.7%, 83.3%, while CYFRA21-1 for diagnosing squamous carcinoma, CEA for diagnosing adenocarcinoma were 63.6% ,64.3% separately. The levels of ProGRP,NSE in the SCLC were apparently higher than NSCLC and benign lung diseases, the differences were statistical significant, while the level of CYFRA21-1 in the NSCLC was evidently higher than the other two groups, the differences were statistical significant. The positive rates of combined measurement of ProGRP and NSE in SCLC was 91.7%. And the positive rates of combined measurement of serum CYFRA21-1, SCCA and CEA in adenocarcinoma, squa- mous carcinoma were 71.4% ,72.7% individually. Conclusion ProGRP and ProGRP ＋ NSE were useful indicators for diagnosing SCLC, CYFRA21-1, CEA were valuable parameter for diagnosing adenocarcinoma and squamous carcinoma respectively.