肺癌患者血清中癌胚抗原和细胞角蛋白片段19的检测与临床价值

目的 探讨血清癌胚抗原(CEA)和细胞角蛋白片段19( CYFRA21-1)检测对肺癌的诊断价值.方法 采用电化学发光法对102例肺癌患者、78例肺部良性病患者和104例健康人血清进行分析,检测CEA和CYFRA21-1水平.结果 肺癌组患者血清中CEA水平及阳性率(25.77±15.34) ng/ml,47.1％]均明显高于肺良性病组(4.67±2.21)ml,7.7％]和健康组(3.98±3.00)ng/ml,3.8％],差异有统计学意义(P＜0.05).肺癌组患者血清中CYFRA21-1水平及阳性率(14.08±8.34)ng/ml,62.7％]也同样高于肺良性病组(3.27±2.87)ml,7.7％]和健康组(2.69±2.02)ng/ml,3.8％],差异有统计学意义(P＜0.05),而良性病组和健康组间差异无统计学意义(P＞0.05).肺癌组患者经TNM分期后,随着肿瘤分期级别的升高,CEA水平Ⅱ～Ⅳ期分别为(17.78±8.71)ng/ml、(25.84±7.34)ng/ml和(34.85±6.99) ng/ml]和CYFRA21-1水平Ⅱ～Ⅳ期分别为(10.05±6.76)ng/ml、(15.93±6.66) ng/ml和(22.78±4.12)ng/ml]也升高.CEA和CYFRA21-1联合检测后,灵敏度增高,特异度降低,准确率基本不变.结论 CEA和CYFRA21-1对肺癌有一定的辅助诊断价值,并且对肺癌的分期有一定诊断价值,联合检测可提高对肺癌的阳性诊断.

Detection and diagnostic value of serum carcinoembryonic antigen and cytokeratin 19 fragment in lung cancer patients

Objective To explore the diagnostic value of carcinoembryonic antigen (CEA) and cytokeratin-19-fragment (CYFRA21-1) in lung cancer patients.Methods The levels of serum CEA and CYFRA21-1 were measured in 102 patients with lung cancer,45 patients with benign lung disease and 36 health controls by electrochemiluminescence.Results The level of serum CEA and positive rate (25.77 ±15.34) ng/ml,47.1％]were significantly higher in the lung cancer group than that in the benign lung disease group (4.67 ±2.21)ml,7.7％; P＜0.05]and controls (3.98 ±3.00) ng/ml,3.8％; P＜0.05 ],The level of serum CYFRA21-1 and positive rate ( 14.08 ± 8.34) ng/ml,62.7％]were also significantly higher in the lung cancer group than that in the benign lung disease group (3.27 ± 2.87 ) ml,7.7％ ; P＜0.05]and controls (2.69 ±2.02 ng/ml,3.8％ ; P＜0.05].The difference of level of CEA and CYFRA21-1 between the benign lung disease group and controls was statistically not significant (P ＞0.05).Both tumor markers were increased to a different degree in the lung cancer patients at various TNM stages (CEA:stage Ⅱ (17.78 ±8.71) ng/ml,stage Ⅲ (25.84±7.34) ng/ml,stage Ⅳ (34.85 ±6.99)ng/ml; and CYFRA21-1:stage Ⅱ (10.05 ±6.76) ng/ml,stage Ⅲ (15.93 ±6.66) ng/ml,stage Ⅳ (22.78 ±4.12) ng/ml].Combined use of both makers showed a significant higher sensitivity (77.5％ vs.47.1％,62.8％ ),but reduced specificity (86.8％ vs.94.0％,95.6％ ),and not significantly changed accuracy (83.5％ vs.77.1％,83.8％ ) in the diagnosis of lung cancer.Conclusions CEA and CYFRA21-1 employed separately are helpful in the diagnosis of lung cancer.Combined detection of these two tumor markers can improve the positivity for diagnosis of lung cancer.