肿瘤标志物联合检测在肺癌早期诊断中的应用

目的：探讨外周血肿瘤标志物癌胚抗原（CEA）、神经元特异性烯醇化酶（NSE）、细胞角质蛋白19片段（CYFRA21-1）、糖链抗原125（CA125）、糖链抗原19-9（CA19-9）、糖链抗原15-3（CA15-3）联合检测在肺癌早期诊断中的应用价值。方法：采用Elecsys2010电化学发光仪检测80例肺癌患者,55例肺部良性疾病患者,40例健康人血清中CEA、NSE、CYFRA21-1、CA125、CA19-9、CA153等肿瘤标志物的水平。结果：肺癌患者中CEA、NSE、CYFRA21-1、CA125、CA19-9、CA153等6种标志物显著高于正常对照组及肺部良性疾病组,差异有统计学意义（P〈0.01）。6项标志物不同组合对不同分期肺癌检出的敏感性均高于单项标志物。其中第6种CY-FRA21-1＋CA125＋NSE和第7种CYFRA21-1＋CA125＋NSE＋CEA组合的敏感性较其他组合均高,特别是对早期患者检出率明显提高,但第7种方式成本较高且6、7两种方式检出率差异无统计学意义。结论：CYFRA21-1＋CA125＋NSE联合检测能提高肺癌的早期诊断率。

Application of serum tumor markers combined detection in early diagnosis of lung cancer

Objective：To evaluate the application value of combined detection of CA125, CA19-9, carcinoembryonie antigen （CEA）, cytokeratin 19 fragment （CYFRA21-1）, neuron-specific enolase （NSE） and CA153 in the early diagnosis of lung cancer. Method：The serum levels of CEA, CYFRA21 1, NSE, CA153, CA19-9 and CA125 of 80 patients with lung ancer,55 patients with benign lung disease and 40 healthy controls were detected by Elecsys 2010 electrochem iluminescence analyzer. Result：The serum levels of six tumor marker were significantly higher in lung cancer patients than those in benign intestinal patients and healthy controls（ P 〈0.01）. The diagnosis sensitivity of tumor marker combined detection were significantly higher than that alone. The combined detections of CYFRA21-1 ,CA125, NSE and CYFRA21- 1,CA125, NSE,CEA were higher than others, especially in early diagnosis of lung cancer,but the cost of combined detection of CYFRA21 1,CA125, NSE,CEA was higher and there was no significant difference between combined detection of CYFRA21-1,CA125, NSE and CYFRA21-1, CA125, NSE, CEA. Conclusion： The combined detection of CYFRA21-1, CA125 and NSE could increase the early diagnosis rate of lung cancer.