血清CEA、CYFRA21-1、NSE、CA724联合检测对肺癌的诊断价值

目的：探讨癌胚抗原（CEA）、细胞角蛋白19片段（CYFRA21-1）、神经特异性烯醇化酶（NSE）、癌抗原72-4（CA724）联合检测对肺癌的诊断价值.方法：采用电化学发光法检测56例肺癌（腺癌组24例,鳞癌组20例,小细胞肺癌组12例）、34例肺部良性疾病（良性疾病组）、30名健康人（对照组）血清CEA、CYFRA21-1、NSE、CA724水平并进行分析.结果：5组血清CEA、CYFRA21-1、NSE和CA724水平差异均有统计学意义（P＜0.01）.腺癌组CEA、鳞癌组CYFRA21-1和小细胞肺癌组NSE均明显高于相应其他4组（P＜0.01）.腺癌组CA724均明显高于对照组和良性疾病组（P＜0.01）.腺癌组CEA、鳞癌组CYFRA21-1、小细胞肺癌组NSE和腺癌组CA724阳性率均高于对照组和良性疾病组（P ＜0.05 ～P＜0.01）.4种标志物单项检测时,特异性为88.9％～ 94.4％,敏感性为28.6％ ～41.1％.联合检测后,特异性略下降（83.3％）,但敏感性明显提高（87.5％）.结论：血清CEA、CYFRA21-1、NSE、CA724水平和肺癌的病理分型有一定的相关性,其联合检测可提高对肺癌的阳性检出率.

The value of the combined detection of serum CEA,CYFRA21-1, NSE and CA724 in the diagnosis of lung cancer

Objective：To investigate the value of the combined detection of carcinoembryonic antigen （CEA）, cytokeratin 19 fragment （ CYFRA21-1 ）, neuron specific enolase （NSE） and carcinoembryonic antigen 72-4 （CA724） in the diagnosis of lung cancer. Methods： The serum levels of CEA, CYFRA21-1, NSE, CA724 in 56 cases with lung cancer（24 cases with adenocarcinoma,20 cases with squamous cell carinoma and 24 cases with small cell carcinoma） ,34 cases with benign pulmonary diseases and 30 healthy people were detected and analysed using electrochemiluminescence. Results： The differences of the serum levels of CEA, CYFRA21-1, NSE and CA724 in five groups were statistical significant（ P 〈 0.01 ）. The levels of CEA in adenocarcinoma group, CYFRA21-1 in squamous cell carcinoma group and NSE in small cell carcinoma group were significantly higher than those in other groups （P 〈 0.01 ）. The level of CA724 in adenocarcinoma group was significantly higher than that in control group and benign disease group（ P 〈 0.01 ）. The positive rates of CEA in adenocarcinoma group, CYFRA21-1 in squamous cell carcinoma group, NSE in small cell carcinoma group and CA724 in adenocarcinoma group were higher than those in control group and benign disease group （P 〈 0.05 to P 〈 0.01 ）. The specificities and sensitivities of the individual detection of 4 kinds of markers were 88.9% to 94.4% and 28.6% to 41.1%, respectively. The specificity and sensitivity of the combined detection of 4 kinds of markers decreased （83.3%） and increased （87.5%）, respectively. Conclusions ：There is certain correlation between the serum levels of CEA, CYFRA21-1, NSE and CA724 and the pathological type of lung cancer,the combined detection of which can improve the postive detection rate of lung cancer.