肿瘤标志物的联合检测在肺癌诊断中的临床价值

目的探讨血清癌胚抗原（CEA）、神经元特异性烯醇化酶（NSE）、糖类抗原125（CA125）、可溶性细胞角蛋白19片段（CYFRA21-1）联合检测在肺癌诊断、病理分型中的临床价值。方法用化学发光法检测133例初治肺癌患者以上4种肿瘤标志物的含量,并与48例肺良性疾病、50例正常人进行对照分析。结果肺癌组各项肿瘤标志物的水平皆明显高于肺良性疾病及正常对照组（P〈0.01）。NSE在小细胞肺癌中阳性率最高为71.4%,CYFRA21-1在肺鳞癌中阳性率最高为75.6%。4项肿瘤标志物联合检测可使肺癌诊断的敏感度由单项检测的45.1%、42.1%、35.3%、49.6%提高到84.2%,准确度由单项检测的64.0%、59.4%、60.2%、67.9%提高到80.3%,而特异度无明显下降。结论多项肿瘤标志物的联合检测可显著提高肺癌诊断的敏感度和准确度,也可为病理分型提供有效的依据。

Clinical value of combined detection of serum tumor markers in diagnosis of lung carcinoma

Objective To investigate the clinical value of combined detection of CEA,CA125,NSE and CYFRA 21-1 in lung cancer. Methods The levels of four tumor markers in 133 cases of primary lung cancer,56 cases of benign lung disease and 50 healthy people were assayed by electrochemiluminesence immuno-assay and were compared. Results The levels of four tumor markers in lung cancer were all significantly higher than those in benign lung diseases and normal controls （P＆lt;0.01）.NSE had the highest positive rate in small cell lung cancer was 71.4%,CYFRA21-1 had the highest positive rate in lung squamous carcinoma was 75.6% .Combination of four tumor markers detection make the sensitivity of the diagnosis of lung cancer by single detection were 45.1%,42.1%,35.3%,49.6% up to 84.2%,the accuracy from single detection of 64.0% , 59.4% , 60.2% , 67.9% up to 80.3% ,but no obvious decline in specific degrees. Conclusion Combined detection of serum CEA,CA125,NSE and CYFRA21-1 promote the diagnostic value of lung cancer patients and provide a reliable evidence for pathological classification.