外周血Cyfra21-1、NSE和Ferritin联合检测对肺癌的诊断价值

目的评价外周血细胞角蛋白19片段（Cyfra21-1）、神经元特异性烯醇化酶（NSE）和铁蛋白（Ferritin）联合检测对肺癌的诊断价值。方法采用电化学发光免疫分析法测定168例肺癌患者、60例良性肺部疾病患者和50例健康体检者外周血的Cyfra21-1、NSE和Ferritin的水平。采用t检验和χ2检验进行数据统计分析。结果肺癌组Cyfra21-1、NSE、Ferritin的水平及阳性率[分别为（15.5±10.1）ng/ml与70.2%,（39.6±13.1）ng/ml与39.9%,（1323.5±861.4）ng/ml与64.9%]明显高于良性肺部疾病组[分别为（9.4±5.6）ng/ml与25.0%,（23.6±8.2）ng/ml与18.3%,（642.4±234.6）ng/ml与34.7%]和健康对照组[分别为（5.9±1.2）ng/ml与10.0%,（18.3±1.8）ng/ml与10.0%,（544.6±135.4）ng/ml与16.0%]（P〈0.01）。随着临床分期逐渐升高,Cyfra21-1、NSE、Ferritin的阳性率和水平也有不同程度升高。就组织类型而言,Cyfra21-1检测阳性率和表达水平以鳞癌较高,NSE的阳性率和表达水平以小细胞癌最高,而Ferritin的阳性率和表达水平则差异不显著。三项联合检测灵敏度达91.1%,与二项或单项比较差异有统计学意义（P〈0.05）。结论外周血Cyfra21-1、NSE和Ferritin联合检测可提高肺癌检出率及对肺癌组织类型鉴别诊断具有重要临床意义。

Significance of Combined Detection of Serum Cyfra21-1 and NSE and Ferritin in Diagnosis of Lung Cancer

Objective To discuss the significance of combined serum detection Cyfra21-1 and NSE and Ferritin in lung cancer diagnosis.Methods Serum Cyfra21-1 and NSE and Ferritin were detected by electrochemiluminescence in 168 cases with lung cancer,50 healthy persons and 60 patients with healthy lungs were enrolled as control group.Results The mean and positive rate of Cyfra21-1 and NSE and Ferritin of lung cancer patients [（15.5±10.1）ng /ml and 70.2%,（39.6±13.1）ng /ml and 39.9%,（1 323.5±861.4）ng /ml and 64.9%] were significantly higher than those in control group（P〈0.01）.The test results were getting higher with more serious clinical stages.Cyfra21-1 was higher in squamous carcinoma,and NSE was highest in little cell lung cancer.The sensitivity of combination of Cyfra21-1 and NSE and Ferritin for the diagnosis of lung cancer is 91.1%.Conclusion The combined determination of Cyfra21-1 and NSE and Ferritin can increase the detection rate of patients with lung cancer and has clinical significance in lung cancer diagnosis.