小细胞肺癌肿瘤标志物：血清NSE与CYFRA21—1和CEA

目的　评价小细胞肺癌 (SCLC)肿瘤标志物血清神经特异性烯醇化酶 (NSE)的诊断价值 ,并与细胞角质蛋白 (CYFRA2 1- 1) ,癌胚抗原 (CEA)进行比较 .方法　采用放射性免疫学方法和化学发光法测定 2 4例SCLC ,92例非小细胞肺癌 (NSCLC)和 118例肺良性疾病患者血清NSE ,CYFRA2 1- 1和CEA .结果　血清NSE对SCLC患者敏感性、特异性和准确率分别为 87.5 %、85 .7%和 85 .0‰ ,SCLC患者血清NSE水平高于NSCLC(p<0 .0 5 ) ,SCLC患者血清NSE灵敏度明显高于CYFRA2 1- 1和CEA(p均 <0 .0 1) .NSE与CYFRA2 1- 1或CEA联合可提高敏感性 .血清NSE水平在SCLC患者化疗前高于正常 ,化疗后 3周升高明显 ,缓解后降至正常 .结论　NSE是一种有效SCLC肿瘤标志物 ,与CYFRA2 1- 1或CEA联合可提高敏感性 ,有效性 ,血清NSE水平还可精确地反映SCLC患者病情变化

Tumor Markers in Small Cell Lung Cancer: Serum NSE Comparison with CYFRA21-1 and CEA

Objective The aim of this study was to evaluate the diagnostic value of serum neuron specific enolase (NSE) as a small cell lung cancer (SCLC) marker,comparison with cytokeratin19 fragment marker (CYFRA21-1) and carcinoembryonic antigen (CEA). Methods The serum levels of NSE , CYFRA21-1 and CEA in 24 patients with SCLC, 92 patient with non-small cell lung cancer (NSCLC) and 118 patients benign lung disease (BLD) were assayed by radioimmunoassay and chemiluminescence. Results The Sensitivity, specificity and diagnostic accuracy rate of NSE in the SCLC patients were 87.5%,85.7%,85.0%. The level of serum NSE in patients with SCLC was higher than the level of NSCLC patients(p<0.05).The Sensitivity of NSE in SCLC is higher than the levels of CYFRA21-1 and CEA (p<0.01).The sensitivity accuracy rate was higher in combined NSE and CYFRA21-1/CEA than the single tumor marker. Serum NSE level ,was elevated before chemotherapy, increased after chemotherapy 3 weeks and decreased to normal level after remission. Conclusions NSE is a effective SCLC tumor marker, the combination with CYFERIH or CEA results in a greater sensitivity and diagnostic accuracy . The serum level of NSE reflects the disease course of patents with SCLC accurately.