联合检测血清CYFRA21-1、CA-125、NSE诊断肺癌的价值

目的　探讨联合检测血清中细胞角蛋白 19血清片段 2 1- 1(CYFRA2 1- 1)、糖链抗原 - 12 5 (CA - 12 5 )、神经元特异性烯醇化酶 (NSE)表达水平对肺癌的诊断价值。方法　应用 EL ISA和化学发光法分别检测 74例肺癌患者 (肺癌组 )和 34例肺良性疾病患者 (肺良性疾病组 )及 5 2例正常人 (正常对照组 )血清 CYFRA 2 1- 1、CA- 12 5、NSE水平。结果　肺癌组血清 CYFRA2 1- 1、CA- 12 5、NSE浓度显著高于正常对照组和肺良性疾病组 (P <0 .0 0 1) ,CYFRA2 1- 1在肺鳞癌中表达水平最高 ,CA- 12 5在肺腺癌中表达水平最高 ,NSE在肺小细胞癌中表达水平最高。血清 CYFRA2 1- 1+CA- 12 5 +NSE联合检测肺癌的敏感性为 90 .4 % ,特异性为 81.3%。结论　联合检测血清 CYFRA2 1- 1、CA- 12 5、NSE水平对肺癌的诊断有重要的临床参考价值。     

CYFRA 21—1在肺癌诊断中的价值

ＣＹＦＲＡ ２１－１在多种上皮肿瘤患者的血清中可见增高，特别是非小细胞肺癌患者血清的水平和阳性率高于其它常用的肿瘤标志物。本文着重综述了ＣＹＦＲＡ ２１－１在非小细胞肺癌诊断及其它临床应用中的价值。     

非小细胞肺癌患者CYFRA21-1的变化及临床意义

非小细胞肺癌 (NSCLC)约占肺癌的 70 % ,就诊时多属中晚期 ,其治疗效果和预后与组织学类型、病变分期有关。近年来多数研究结果证明 ,细胞角蛋白 19(CYFRA2 1-1)在肺癌患者的血清含量中最高 ,尤其是在非小细胞肺癌患者中更明显。为此 ,我们使用法国 CIS公司提供的 CYFRA2 1-1试剂盒 ,检测了 79例非小细胞肺癌患者手术前后血清中 CYFRA2 1-1含量 ,以探讨其临床价值。现报告如下。资料与方法 :本组 79例中 ,男性 5 8例 ,女性 2 1例 ;年龄2 5～ 74岁 ;均经手术治疗、病理检查证实为非小细胞肺癌。其中鳞癌 3 5例 ,腺癌 3 3例 ,其他类…     

CEA、NSE、CYFRA21-1在肺癌诊断中的价值研究

目的:探讨与肺癌相关的常见肿瘤标志物CEA、CYFRA21-1、NSE在原发性肺癌诊断中的意义。方法:测定50例肺癌患者和20例肺部良性肺疾病的血清CEA、CYFRA21-1、NSE水平,结合其临床资料．分析其临床诊断价值。结果:CEA、CYFRA21-1、NSE分别在肺腺癌、肺鳞癌及小细胞肺癌具有较高的敏感性．且与肿瘤分期有一定的相关性。结论:三者联合检测可提高肺癌的盗床诊断率。     

血清CYFRA21-1在肺鳞状细胞癌中的诊断价值

肺癌是临床上最为常见的恶性肿瘤之一,其病死率在城市人口恶性肿瘤死亡中已居首位。总的五年生存率目前仅13％-15％。其中非小细胞肺癌约占肺癌总数的80％。尽管过去20年肺癌的治疗手段有了很大进展,但肺癌患者的预后却无明显改善,主要原因在于目前未能有效的对肺癌的早期进行诊断。目前临床上常用的肺癌诊断方法有：X线、CT、痰液脱落细胞学检查、组织活检（支气管镜、穿刺、胸腔镜活检等）等方法。     

支气管肺泡灌洗液和血清CEA、CYFRA21—1检测对肺癌诊断价值的研究

目的研究支气管肺泡灌洗液（BALF）和血清中癌胚抗原（CEA）、细胞角蛋白19片段（CYFRA21—1）的检测在肺癌诊断中的价值。方法将近来在我院行纤维支气管镜检查的门诊或住院患者38例,分为2组,即肺癌组18例和肺良性病变组20例,纤支镜灌洗留取BALF和采集空腹血清,分别测定CEA、CYFRA21—1。结果肺癌组患者BALF和血清CEA、CY—FRA21-1的水平明显高于肺良性病变组,经比较有显著性差异（P〈0．01）;单个检测BALF和血清CEA、CYFRA21—1的敏感性为61．1％～72．2％,特异性65％～80％;联合检测BALF和血清CEA、CYFRA21—1的敏感性为44．4％～50．6％,较低,但特异性较高。为95％-100％,且准确性增加。结论BALF和血清CEA、CYFRA21—1的检测有助于肺癌的诊断,且支气管肺泡灌洗液CEA、CYFRA21—1的敏感性和特异性较血清高,联合检测能提高肺癌诊断的特异性和准确性。     

血清CYFRA21-1、NSE和CEA在非小细胞肺癌辅助诊断中的应用

目的探讨血清细胞角蛋白片段21-1(CYFRA21-1)、神经元特异性烯醇化酶(NSE)、癌胚抗原(CEA)在非小细胞肺癌(NSCLC)辅助诊断中的应用价值。方法采用免疫学方法检测82例NSCLC患者(NSCLC组)、62例肺部良性疾病患者(良性疾病组)和62例健康体检者(对照组)CYFRA21-1、NSE、CEA的表达,进而对其检测结果进行相互对比分析。结果 NSCLC组的CYFRA21-1、NSE、CEA表达水平及阳性率显著高于良性疾病组和对照组(P<0.05);不同病理类型NSCLC患者的CYFRA21-1、NSE、CEA阳性率差异均无统计学意义(P>0.05);CYFRA21-1+NSE+CEA与CYFRA21-1+NSE两种组合的灵敏度最高,CEA和NSE两种组合的特异度最高,CYFRA21-1+NSE和CYFRA21-1+CEA两种组合的正确指数最高,CYFRA21-1+NSE和CEA的阳性预测值最高,而CYFRA21-1+NSE+CEA和CYFRA21-1+NSE的阴性预测值最高。结论 CYFRA21-1、NSE、CEA均在NSCLC患者体内呈现高表达,但在鉴别NSCLC病理类型上有一定的缺陷,CYFRA21-1组合NSE可显著提高NSCLC的诊断效能。     

血清HE4、NSE、CYFRA21-1水平变化对肺癌的诊断价值

目的探讨血清HE4、NSE、CYFRA21-1水平变化对肺癌的诊断价值。方法采用电化学发光法检测88例肺癌患者和70例肺良性疾病患者及50例健康对照者血清中的HE4、NSE、CYFRA21-1水平。结果肺癌组血清HE4、NSE、CYFRA21-1水平明显高于肺良性疾病组和健康对照组(P0.05);腺癌、鳞癌、小细胞肺癌分别以HE4、CYFRA21-1、N SE检测敏感性最高(P0.05);HE4、NSE、CYFRA21-1联合检测较单项检测诊断敏感性显著提高(P0.05)。结论 HE4、NSE、CYFRA21-1水平变化有助于肺癌的诊断和鉴别诊断,三项肿瘤标志物联合检测优于各项目单独检测。     

血清CEA、NSE、SCC-Ag、CYFRA21-1联合检测对肺癌的诊断价值

目的研究血清肿瘤标志物癌胚抗原（CEA）、神经元特异性烯纯化酶（NSE）、鳞状细胞癌相关抗原（SCC-Ag）及细胞角蛋白（CYFRA21-1）对肺癌诊断的价值。方法用酶联免疫吸附实验法（ELISA）检测对97例肺癌患者、90例良性肺疾病患者及85例健康对照组进行血清CEA、NSE、SCC-Ag及CYFRA21-1水平,并计算上述指标单项及联合检测在肺癌诊断中的敏感度和特异度。结果肺癌患者的血清CEA、NSE、SCC-Ag及CYFRA21-1水平均明显高于良性肺部组和健康对照组（P〈0.05）;4项标记物在不同病理类型肺癌中总体比较均有差异,其中CEA阳性率以腺癌最高（55.26%）,SCC-Ag、CYFRA21-1阳性率以鳞癌最高（分别为70.43%,72.38%）,NSE阳性率以小细胞肺癌最高（67.92%）。血4项标志物联合检测肺癌阳性率（92.78%）高于单项检测结果。结论血清CEA、NSE、SCC-Ag、CYFRA21-1联合检测不仅有助于区分肺癌的病理分型,还能明显提高肺癌诊断的敏感性和检出率。     

肿瘤标志物SCC-Ag、NSE、CYFRA21-1、CEA联合检测在肺癌诊断中的应用价值

目的探讨肿瘤标志物SCC．Ag、NSE、CYFRA21—1、CEA联合检测在肺癌诊断中的应用价值。方法选择我院42例经病理检查确诊的肺癌患者,设为癌症组,42例良性肺疾病患者作为良性组,42例健康体检者作为对照组,所有患者均采用化学发光法对血清SCC—Ag、NSE、CYFRA21-1、CEA联合检测,观察联合检测的敏感性和特别性。结果癌症组四种肿瘤标志物水平明显高于良性组与对照组,组间比较差异具有显著性P〈0．05。单一肿瘤标志物检测具有较高的特异性,但灵敏度及准确率不高,联合检测大大提高了灵敏度与准确性,联合检测与单一检测灵敏度与准确率比较差异具有显著性P〈0．05。结论肿瘤标志物SCC．Ag、NSE、CYFRA21—1、CEA联合检测可明显提高检出率,同时还可对肺癌患者进行病理分型,具有重要的临床价值。     

Serum CYFRA 21-1 in cervical cancer patients treated with radiation therapy

Background: A fragment of cytokeratin 19, referred to as CYFRA 21-1, is abundant in the serum of many patients with malignant tumors and is recognized as one of the established tumor markers, especially for non-small-cell lung cancer. In this study, the clinical usefulness of CYFRA 21-1 was investigated in cervical cancer patients treated with radiation therapy with reference to squamous-cell-carcinoma-related antigen (SCC-Ag), a common tumor marker of cervical squamous cell carcinoma. Materials and methods: The serum levels of CYFRA 21-1 and SCC-Ag of 50 patients with squamous cell carcinoma of the uterine cervix were measured before and after radiation therapy. Results: CYFRA 21-1 was positive in 52% of the patients. The incidence increased with the stage of the cancer, and post-treatment increases were a sign of disease progression. During radiation, serum levels of CYFRA 21-1 decreased significantly and reflected the radiation effect well. In addition, CYFRA 21-1 was negative in all patients without distant metastasis at the end of radiation therapy. Compared with SCC-Ag, patients were less often positive for CYFRA 21-1, but there was a statistically positive correlation between the two markers (correlation matrix = 0.69). Conclusions: CYFRA 21-1 can be used in monitoring the outcome of patients with squamous cell carcinoma of the uterine cervix. It may be particularly useful for patients without SCC-Ag. Received: 8 September 1999 / Accepted: 22 December 1999     

Diagnostic utility of CYFRA 21-1 in malignant pleural effusion

OBJECTIVE: The diagnostic utility of the tumour marker CYFRA 21-1 in malignant pleural effusion is not yet clear. This study was designed to evaluate the diagnostic utility of serum and pleural fluid CYFRA 21-1 in malignant pleural effusion. METHODOLOGY: The validity of serum and pleural fluid CYFRA 21-1 was determined in 62 patients with exudative pleural effusion (27 malignant and 35 benign). The diagnosis of malignant pleural effusion was defined by cytological or histological results. RESULTS: A statistically significant difference between the geometric means of CYFRA 21-1 levels in pleural fluid of benign and malignant aetiologies was observed (11.2 vs 63.3 ng/mL, P < 0.0001). In addition, there was a significant difference in the serum levels (0.95 vs 5.55 ng/mL, P < 0.0001). The sensitivity and specificity of pleural fluid CYFRA 21-1 in malignant pleural effusion, at the cut-off value of 55 ng/mL, was 74.1% and 97.1%, respectively. The sensitivity and specificity of serum CYFRA 21-1, at the cut-off value of 2.5 ng/mL, was 81.5% and 97.1%, respectively. Using a combination of serum and pleural fluid CYFRA 21-1 level, the sensitivity increased to 88.9%. CONCLUSION: Serum and pleural fluid CYFRA 21-1 are useful as measures in differentiating malignant from benign pleural effusion.     

细胞角质片段21-1、神经元特异性烯醇化酶在肺癌早期诊断中应用价值的探讨

目的　评价肿瘤标记物细胞角质片段 2 1 1(CYFRA2 1 1)、神经元特异性烯醇化酶(NSE)对肺癌早期诊断的价值。方法　将 3 0例肺癌患者分为非小细胞性肺癌组 (NSCLC)和小细胞性肺癌组 (SCLC) ,良性疾病患者为对照组。所有患者均经支气管镜检查进行患侧和健侧肺泡灌洗 ,收集肺泡灌洗液 (BALF) ,同时采静脉血 ,按放射免疫方法 (RIA)检测CYFRA2 1 1、NSE。结果　CYFRA2 1 1水平在NSCLC中明显高于SCLC和良性疾病患者。NSE则在SCLC中显著高于NSCLC和良性疾病组。各组BALF中CYFRA2 1 1、NSE水平均以患侧增高明显 (P <0 .0 5或0 .0 1) ,CYFRA2 1 1、NSE联合检测与各单项指标相比 ,正确率提高 ,以患侧BALF联合检测方法最优。结论　联合检测患侧BALF中CYFRA2 1 1、NSE的含量诊断肺癌的阳性率最高 ,准确性达97.14 %。     

血清细胞角蛋白19片段检测对肺癌的临床意义

目的确定我国肺癌患者血清细胞角蛋白１９片段（ＣＹＦＲＡ２１－１）浓度阈值，探讨其临床应用价值。方法应用单克隆抗体（Ｋｓ１９．１和ＢＭ１９．２１）检测７２例初次确诊肺癌患者和５０例肺良性疾病患者以及３３例治疗后肺癌患者血清ＣＹＦＲＡ２１－１水平。采用ＲＯＣ曲线确定ＣＹＦＲＡ２１－１浓度阈值。结果（１）肺癌患者血清ＣＹＦＲＡ２１－１水平显著高于肺良性疾病患者（Ｐ＜０．００１），鳞癌显著高于其它病理类型，且其浓度随临床分期升高而升高。（２）当阈值定为５．５μｇ／Ｌ时，ＣＹＦＲＡ２１－１检测肺癌的敏感性、特异性分别为６３％和９４％。鳞癌敏感性最高为７８％。（３）ＣＹＦＲＡ２１－１检测非小细胞肺癌的敏感性随临床分期升高而升高。（４）ＣＹＦＲＡ２１－１是监测肺癌病情、提示疗效的良好指标。（５）当ＣＹＦＲＡ２１－１作为筛检肺癌的指标时，阈值宜取非小细胞肺癌Ｉ－ＩＩ期ＲＯＣ曲线拐点，但对非小细胞肺癌早期诊断作用有限。结论ＣＹＦＲＡ２１－１是一较好的非小细胞肺癌肿瘤标记物，尤其适用于肺鳞癌     

Serum CYFRA 21-1 level reflects hepatocellular carcinoma metastasis: study in nude mice model and clinical patients

Our previous proteomics study on human hepatocellular carcinoma (HCC) cell strains revealed that cytokeratin 19 (CK19) was expressed in cells with high metastasis potential; we further studied serum CK19 fragment CYFRA 21-1 level in HCC patients and nude mice model of HCC metastasis. HCC cell line HCCLM3 was injected subcutaneously into 30 nude mice which were then randomized into 6 groups of 5 mice each. The murine serum CYFRA 21-1 and pulmonary metastases were determined 2, 3, 4, 5, 6, and 7 weeks after injection. Serum CYFRA 21-1 levels of 101 normal controls and 108 HCC patients were also determined. In nude mice model, CYFRA 21-1 level increased significantly when pulmonary metastases occurred. Among 108 HCC patients, 24 (22.2%) had increased serum CYFRA 21-1 level. The presence of portal vein tumor emboli was significantly higher in CYFRA 21-1 increased cases (33.3%, 6/24) than in CYFRA 21-1 normal cases (6.0%, 5/84) (x ² = 7.403, P < 0.01). In addition, the percentage of TNM stage III/IV tumor was significantly higher in CYFRA 21-1 increased patients (54.2%, 13/24) than in CYFRA 21-1 normal cases (21.4%, 18/84) (x ² = 9.776, P < 0.005). These results suggest that CK19 may play an important role in HCC metastasis.     

Intrahepatic cholangiocarcinoma with increased serum CYFRA 21-1 level

CYFRA 21-1 is a fragment of cytokeratin 19 (CK 19). Four patients with large intrahepatic (or peripheral) cholangiocarcinoma (CC) and high serum levels of CYFRA 21-1 (normal, ≤2 ng/ml) are reported. CYFRA 21-1 levels exceeded 9 ng/ml in all 4 patients. Carcinoembryonic antigen (CEA), was high in 1 (CEA; normal range, ≤5.0 ng/ml) and carbohydrate antigen 19-9 (CA 19-9) was high in 3 (CA19-9; normal range, ≤36 U/ml). We also measured serum levels of CYFRA 21-1 in 13 patients with hepatocellular carcinoma (HCC) more than 5 cm in diameter. Levels of CYFRA 21-1 exceeded 2 ng/ml in 9 of the HCC patients and were higher than 9 ng/ml in 2 of the HCC patients. Levels of alpha fetoprotein (AFP) and/or protein induced by vitamin K absence or antagonist II (PIVKA II) were elevated in all HCC patients (AFP, PIVKA II, respectively; normal range, ≤10.0 ng/ml and ≤0.1 AU/ml) CYFRA 21-1 levels were measured twice or three times during the clinical course in 2 CC patients and in 6 HCC patients, and increased gradually with tumor growth in the 2 CC patients and in 3 of the 6 HCC patients. Marked increases in serum CYFRA 21-1 levels in patients with large liver cancers, particularly in those with normal levels of AFP and PIVKA II, would suggest the existence of intrahepatic CC rather than HCC. (Received May 8, 1997; accepted Oct. 30, 1997)     

血清TPS,CEA,CYF RA2 1-1,NSE联合检测对肺癌的诊断价值

目的探讨血清TPS、CEA、CYFR A21-1、NSE联合检测对肺癌的诊断价值。方法采用ELISA法及电化学发光法对72例肺癌（其中鳞癌30例,腺癌2 8例,小细胞癌14例）患者血清TPS、CEA、CYFRA21-1和NSE水平进行检测,并与42例肺部良性病患者和30例健康人血清进行分析。结果肺癌患者血清4种肿瘤标志物含量明显高于肺部良性疾病组（P〈0.001）和健康对照组（P〈0.001）。4种肿瘤标志物单项检测时,特异度较高（76.4%-91.5%）,但敏感度不是很高（45.8%-83.3%）。联合检测后,可提高肺癌的阳性检出率（100%）。结论 TPS、CEA、CYFRA21-1和NSE对肺癌有一定的辅助诊断价值,且CEA、NSE和CYFRA21-1对不同组织类型肺癌均有一定诊断价值,联合检测可提高对肺癌的阳性诊断。     

Cytokeratin Fragment 19 (CYFRA 21-1) and Carcinoembryonic Antigen for Early Prediction of Recurrence of Lung Adenocarcinoma

Fifty patients with adenocarcinoma of the lung were enrolled in this study, including 20 patients with recurrence and 30 patients without recurrence 1 year after surgery. Serial serum levels of cytokeratin fragment 19 (CYFRA 21-1) and carcinoembryonic antigen (CEA) were measured before the operation and 1 week, 1 month, 3 months, 6 months, 9 months, and 12 months after surgery for the early detection of recurrence. The results revealed that the mean serum values of either CYFRA 21-1 or CEA were significantly higher until 9 and 12 months after surgery in the 20 patients with recurrent adenocarcinoma compared with the 30 patients without recurrent adenocarcinoma. We conclude that CYFRA 21-1 is not a better marker than CEA for early prediction of adenocarcinoma. We conclude that CYFRA 21-1 is not a better marker than CEA for early prediction of adenocarcinoma recurrence in lung. Accepted for publication: 7 July 1999