血清肿瘤标志物CYFRA21-1、CEA、NSE检测在肺癌辅助诊断中的应用

目的探讨血清肿瘤标志物细胞角蛋白19片段(Cytokeratin fragment 19,CYFRA21-1)、神经元特异性烯醇化酶(Neuron-specific enolase,NSE)、癌胚抗原(Carcinoembryonic antigen,CEA)单独或联合检测对肺癌的诊断价值。方法应用电化学发光技术测定经病理确诊的肺癌患者182例、肺良性疾病患者78例及健康对照者85例血清肿瘤标志物CYFRA21-1、CEA、NSE的含量水平,并计算各项目的阳性率、灵敏性、特异性、准确性等诊断性能指标。结果肺癌组3项肿瘤标志物水平显著高于肺良性疾病组及健康对照组(P0.01);CYFRA21-1在肺鳞癌、CEA在肺腺癌、NSE在小细胞肺癌的水平及阳性率分别显著高于其他两组(P0.01);CYFRA21-1、CEA、NSE联合检测可提高肺癌诊断的灵敏性和准确性(P0.01)。结论 CYFRA21-1、CEA、NSE单项检测分别对肺鳞癌、肺腺癌、小细胞肺癌诊断性能最高,且3项联检优于单项检测。

The diagnostic value for combination of 3 serum tumor markers CYFRA21-1,CEA and NSE in lung cancer

Objective To investigate the clinical diagnosis value in lung cancer to combine three serum tumor marker CYFRA21-1,CEA and NSE.Methods To analyze retrospectively the diagnosis sensitivity and specificity of CYFRA21-1,CEA and NSE in 182 cases with lung cancer（containing squamous cell carcinoma 72 cases,adenocarcinoma 64 cases and small cell lung cancer 46 cases） in 78 lung innocence disease group and 85 health adults（control group）.Results The serum tumor marker levels in the lung cancer group were significantly higher than those in benign lung disease group and control group（P 0.01）;The diagnostic value was best for CYFRA21-1,CEA and NSE in squalors cell carcinoma,Aden carcinoma and small cell lung cancer respectively（P 0.01）;These three TM combinations may be more sensitive,and helpful in the diagnosis of lung cancer.Conclusion Combination of multiple tumor markers can increase the clinical diagnosis value in lung cancer.