67例肺癌ECT全身骨显像及血清Cyfra21-1、NSE、CEA、CA125联合测定分析

Objective To explore the correlation between Cyfra21-1、 NSE、 CEA、CA125 and the bone metastasis in lung cancer.Methods Images were obtained on a gamma camera (E.CAM,Siemens,Erlangen,Germany)using 99mTC-MDP as a skeletal imaging agent.67 cases diagnosed as lung cancer were performed by ECT bone imaging,serum concentration of Cyfra21-1,NSE,CEA and CA125 were measured among 30 healthy individual,33 patients with pulmonary tuberculosis and 67 patients with lung cancer by electrogenerated chemiluminescence(ECL) (Roche,Germany).Results The serum Cyfra21-1、NSE、CEA、CA125 from lung cancer were higher than that of controls group and pulmonary tuberculosis group(P<0.01).and the pleural Cyfra21-l and NSE were significantly higher than that in serum.In lung cancer,there are correlation between tumor marker and its pathological types.Cyfra21-1 concentration in squamous cell carcinoma were significantly higher than that of other lung cancers(P<0.01),NSE level in small cell lung cancer were significantly higher than that other lung cancers(P<0.01).33 patients with lung cancer had no obvious sign of bone metastases among 67 cases (accounting for 49.3%),34 patients had bone metastases with varying degrees(accounting for 50.7 % ) ;Adenocarcinoma has highest incidence of bone metastasis( 64 % ),followed by small cell lung cancer and squamous cell carcinoma.Cyfra21-land NSE level is highest in cases with wide spread bone metastasis,followed by those with part bone metastasis and without bone metastasis in turn.Conclusion There are relationship between tumor marker and bone metastasis of lung cancer.Multiple bone metastases often were accompanied by obvious change of serum tumor marker.Cyfra21-lis a useful tool in diagnosis of non-small cell lung cancer,especially in squamous cell carcinoma.NSE is useful to identify the small cell lung cancer.Combined determination of Cyfra21-1,NSE,CEA and CA125 can improve sensitivity,accuracy and positive rate of diagnosis lung cancer.It seems that the whole body bone imaging combined Cyfra21-1,NSE,CEA and CA125 detection have important clinical value in diagnosis and identification of lung cancer.     

67例肺癌ECT全身骨显像及血清Cyfra21-1、NSE、CEA、CA125联合测定分析

Objective To explore the correlation between Cyfra21-1、 NSE、 CEA、CA125 and the bone metastasis in lung cancer.Methods Images were obtained on a gamma camera (E.CAM,Siemens,Erlangen,Germany)using 99mTC-MDP as a skeletal imaging agent.67 cases diagnosed as lung cancer were performed by ECT bone imaging,serum concentration of Cyfra21-1,NSE,CEA and CA125 were measured among 30 healthy individual,33 patients with pulmonary tuberculosis and 67 patients with lung cancer by electrogenerated chemiluminescence(ECL) (Roche,Germany).Results The serum Cyfra21-1、NSE、CEA、CA125 from lung cancer were higher than that of controls group and pulmonary tuberculosis group(P<0.01).and the pleural Cyfra21-l and NSE were significantly higher than that in serum.In lung cancer,there are correlation between tumor marker and its pathological types.Cyfra21-1 concentration in squamous cell carcinoma were significantly higher than that of other lung cancers(P<0.01),NSE level in small cell lung cancer were significantly higher than that other lung cancers(P<0.01).33 patients with lung cancer had no obvious sign of bone metastases among 67 cases (accounting for 49.3%),34 patients had bone metastases with varying degrees(accounting for 50.7 % ) ;Adenocarcinoma has highest incidence of bone metastasis( 64 % ),followed by small cell lung cancer and squamous cell carcinoma.Cyfra21-land NSE level is highest in cases with wide spread bone metastasis,followed by those with part bone metastasis and without bone metastasis in turn.Conclusion There are relationship between tumor marker and bone metastasis of lung cancer.Multiple bone metastases often were accompanied by obvious change of serum tumor marker.Cyfra21-lis a useful tool in diagnosis of non-small cell lung cancer,especially in squamous cell carcinoma.NSE is useful to identify the small cell lung cancer.Combined determination of Cyfra21-1,NSE,CEA and CA125 can improve sensitivity,accuracy and positive rate of diagnosis lung cancer.It seems that the whole body bone imaging combined Cyfra21-1,NSE,CEA and CA125 detection have important clinical value in diagnosis and identification of lung cancer.     

肺癌患者全身骨显像联合血清Cyfra21-1、NSE、降钙素检测诊断骨转移的临床意义

目的：通过99mTc-MDP全身骨显像与血清细胞角蛋白19（CK19）可溶性片段Cyfra21-1、神经元特异性烯醇化酶（NSE）、降钙素的联合检查,探讨对肺癌骨转移的诊断价值。方法：对120例经病理或穿刺活检证实为肺癌的患者行全身骨显像。在行全身骨显像的前后1周内进行Cyfra21-1、NSE、降钙素测定。结果：120例肺癌患者中71例发生骨转移,占59.17%,其中单发者为14例,占19.72%,多发者为57例,占80.28%.肺癌骨转移患者以肋骨转移最多,其次是脊柱,再次是骨盆。肺癌骨转移组Cyfra21-1、NSE水平明显高于未转移组（P<0.05）,肺癌骨转移组、未转移组Cyfra21-1、NSE水平明显高于肺部良性病变组（P<0.01）,肺癌骨转移组降钙素水平明显高于未转移组及肺部良性病变组（P<0.01）。血清Cyfra21-1、NSE、降钙素水平与骨转移程度有一定的相关性,多发骨转移中此3项值最高。血清Cyfra21-1在非小细胞肺癌中高表达,尤其是肺鳞癌;血清NSE在小细胞肺癌中高表达。结论：全身骨显像联合Cyfra21-1、NSE、降钙素测定,对于诊断骨转移,特别是肺癌术前发生的单发骨转移有重要的临床意义。     

联合检测CEA、CA125、NSE、Cyfra21-1对肺癌术后复发的诊断价值

目的：联合检测CEA、CA125、NSE、Cyfra21-1对肺癌术后复发的诊断价值。方法：监测44例肺癌患者术后和复发后的肿瘤标记物CEA、CA125、NSE和Cyfra21-1的变化。结果：期和复发者肿瘤标志物阳性的数目比期、期者多。联合检测三项或四项阳性者100%确诊为肺癌术后复发,两项阳性者为70%,一项阳性者为43%。结论：联合检测肿瘤标志物对肺癌术后复发的诊断具有重要的意义。     

联合检测血清IGF-1、CEA、CYFRA21-1、NSE、CA199在肺癌诊治中的应用

目的探讨血清胰岛素样生长因子（IGF-1）、癌胚抗原（CEA）、细胞角蛋白19片段（CYFRA21-1）、神经特异性烯醇酶（NSE）、糖类蛋白19-9（CA19-9）联合检测在肺癌诊治中的具体应用价值。方法对98例肺癌组患者治疗前后,46例肺良性病变组患者,42例健康组受检者使用化学发光免疫分析法检测血清5项肿瘤标志物的表达水平,并进行比较分析。结果肺癌组患者血清5项肿瘤标志物均明显高于肺良性病变组和健康组（P〈0.05）。肺癌细患者治疗后血清5项肿瘤标志物水平明显下降（P〈0.05）。肺癌组中Ⅲ/Ⅳ期患者血清5项肿瘤标志物含量均明显高于Ⅰ/Ⅱ期（P〈0.05）。腺癌中CEA表达水平明显高于小细胞肺癌和鳞癌（P〈0.05）,小细胞肺癌中NSE表达水平明显高于腺癌和鳞癌（P〈0.05）,鳞癌中CYFRA21-1表达水平明显高于小细胞肺癌和腺癌（P〈0.05）。联合检测血清5项肿瘤标志物对肺癌的效能最高为0.986。结论肿瘤标志物在肺癌疾病的发展过程中表现出一定的差异性,特别是多项指标的联合检测对于肺癌的诊断、分期及疗效判定具有一定的临床应用价值。     

310例肺癌骨转移患者核素全身骨显像分析

目的：探讨肺癌骨转移患者图像特点及规律。方法：使用SPECT双探头仪对310例肺癌患者进行核素全身骨显像,必要时加做局部静态显像。结果：①肺癌骨转移患者中,腺癌阳性率最高（64.83%）;②肋骨为最多见转移部位（263例）;③多发转移病灶250例,占80.6%,单发转移病灶60例,占19.3%。结论：放射性核素全身骨显像能较X线、CT提前3～6个月发现骨转移病灶,是目前临床上诊断骨转移的首选检测方法;周围型肺癌患者骨转移发生率高于中央型肺癌患者;对于不典型的异常病灶应通过补充X线摄片、CT检查最终明确诊断;骨显像异常病灶的数目与患者的预后相关。     

肺癌骨转移107例全身骨显像的临床应用分析

目的：探讨骨显像对肺癌骨转移患者的临床应用价值。方法：对我院107例肺癌患者进行全身骨显像。结果：肺癌骨转移多发于腺癌并且以胸部骨转移最常见。结论：全身骨显像在肺癌临床应用上有较高的价值。     

联合检测CEA、NSE和CYFRA21-1在肺癌诊断中的价值

目的探讨肿瘤标志物CEA、NSE和CYFRA21-1联合检测对肺癌的诊断价值。方法检测不同病理类型肺癌患者的血清中CEA、NSE和CYFRA21-1水平。结果肺癌组血清CEA、NSE和CYFRA21-1水平明显高于肺良性疾病患者(P0.05);CEA+NSE+CYFRA21-1诊断灵敏度明显高于单项肿瘤标志物(P0.05)。结论血清CEA、NSE和CYFRA21-1联合检测有助于肺癌临床诊断。     

肺癌患者手术前后血清NSE、CYFRA21-1、CEA的变化及临床意义

目的 探讨血清神经元烯醇化酶(NSE)、细胞角蛋白19片段(CYFRA21-1)及癌胚抗原(CEA)在肺癌患者手术前后的水平变化及临床意义.方法 选择肺癌患者105例,肺良性病变患者54例.采用电化学发光法检测了手术前后血清NSE、CYFRA21-1、CEA水平.结果 肺癌组血清NSE和CYFRA21-1、CEA水平高于胃良性疾病组,差异有统计学意义(P<0.01).肺癌患者行根治性手术组术后血清NSE、CYFRA21-1、CEA水平明显低于手术前,差异有统计学意义(P<0.01).结论 手术切除肿瘤特别是行根治性切除术后,血清NSE、CYFRA21-1、CEA水平显著降低,动态观察NSE、CYFRA21-1、CEA水平及其变化,对肺癌的辅助诊断、预后判断有重要的价值.     

联合检测CEA、NSE和CYFRA21-1在肺癌诊断中的价值

Objective To investigate the diagnostic value of Joint determination of CEA,NSE and CYFRA21-1 in serum from patients with lung cancer.Methods Detected the CEA、NSE、CYFRA21-1 in different type patients with lung cancer.Results In lung cancer group,the levels of CEA,NSE and CYFRA21-1 were significantly higher than those group of benign lung disease (P<0.05).The sensitivity of joint measurement CEA,NSE and CYFRA21-1 was significantly higher than that of each tumor marker(P<0.05).Conclusion Joint measurement of CEA,NSE and CYFRA21-1 is helpful to diagnosis of lung cancer.     

血清肿瘤标志物CA125、CA199、CEA、NSE联合检测在肺癌诊断中的应用

目的探讨血清肿瘤标志物CA125、CA199、CEA、NSE联合检测在肺癌诊断中的应用价值。方法选择本院2009年1月至2010年2月住院的肺癌患者220例肺癌病例组,选取同期我院健康体检人员为正常对照组250例,进行肿瘤标志物CA125、CA199、CEA、NSE进行联合检测。结果经统计学分析肺癌病例组CA125、CEA、NSE血清水平明显高于正常对照组,差异有显著性意义（P〈0．01）,CA199在两组的表达水平比较无显著性差异（P〉0．05）。经统计学分析CA125、CEA、NSE与联合检测三项肿瘤标志物之间的敏感性、特异性比较有显著型差异（P〈0．01）。结论单项肿瘤标志物检测,可以对临床有一定的指导性,但在敏感性、特异性均方面各有欠缺,很多肿瘤标志物与其他相应的疾病有一定的交叉性,对单项肿瘤标志物检测指导临床诊断价值有限,同时选用多项肿瘤标志物进行检测,可以达到单项检测在敏感性和特异性上的不足,能够有效的为临床提供有价值的佐证资料,以能够达到初筛和早期诊断的目的。     

联合检测5项标志物在肺癌诊断中的应用价值

目的研究癌胚抗原(CEA)、糖类抗原125(CA125)、细胞角蛋白片段21-1(CYFRA21-1)、神经元特异性烯醇化酶(NSE)和CA19-9联合检测在肺癌诊断中的应用价值。方法抽取患者餐前空腹静脉血,检测血清CEA、CA125、CYFRA21-1、NSE和CA19-9。同时检测健康体检组各项指标进行对比。结果肺癌组5项检测指标平均值均明显高于健康对照组,差异有统计学意义(P<0.05)。联合检测肿瘤指标明显提高了肺癌诊断的灵敏性和特异性。结论联合检测CEA、CA125、CYFRA21-1、NSE和CA19-9对肺癌的早期诊断具有重要意义。     

CYFRA21-1、NSE、CEA和CA125检测在肺癌诊断中应用探讨

目的 探讨神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段(CYFRA21-1)、癌胚抗原(CEA)、糖类抗原125(CA125)联合测定对肺癌的诊断价值。方法 应用化学发光波对62例肺癌及30名健康人血清进行检测。结果 神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段(CYFRA21-1)、癌胚抗原(CEA)、糖类抗原125(CA125)水平及检测阳性率均明显高于良性肺病及正常对照组(P<0.01)。鳞癌、腺癌和小细胞肺癌分别以CYFRA21-1、CEA、NSE升幅较为明显。结论 神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段(CYFRA21-1)、癌胚抗原(CEA)、糖类抗原125(CA125)联合检测可明显提高肺癌的阳性检出率和检测特异性,对肺癌的早期诊断、疗效监测、预后判断有重要意义。     

NSE、Cyfra21-1、CEA及CA125在孤立性肺结节诊断中的价值

目的探讨NSE、Cyfra21-1、CEA及CA125四种肿瘤标志物在孤立性肺结节诊断中的价值。方法收集经胸部X线、CT诊断的孤立性肺结节患者70例,将术后病理确诊为肺癌的52例作为肺癌组,良性病变18例作为肺部良性疾病组。检测所有入选患者血清中NSE、Cyfra21-1、CEA及CA125水平。结果肺癌组NSE和Cyfra21-1水平均显著高于肺部良性疾病组(P<0.05),而2组CEA、CA125水平比较差异无统计学意义(P>0.05)。NSE单独检测诊断肺癌的灵敏度为48.1%,特异度为77.8%;Cyfra21-1单独检测诊断肺癌的灵敏度为61.5%,特异度为77.8%;两项联合检测诊断肺癌的灵敏度为78.8%,特异度为66.7%。结论 NSE和Cyfra21-1水平在孤立性肺结节肺癌患者中显著高于良性病变者,NSE和Cyfra21-1检测对孤立性肺结节的诊断有一定价值。     

联合检测血清中4种肿瘤标志物对肺癌的诊断价值

目的探讨血清癌胚抗原(CEA)、细胞角质蛋白(Cyfra21‐1)、鳞状上皮细胞癌抗原(SCC‐Ag)和神经烯醇化酶(NSE)对肺癌诊断的价值.方法采集65例肺癌患者(其中腺癌28例、鳞癌25例、小细胞肺癌12例)和40例肺部良性病变患者血清标本,采用电化学发光免疫法检测.结果CEA 、Cyfra21‐1、SCC‐Ag 和 NSE 在肺癌组的灵敏度分别为46.2%、40.0%、43.1%和46.2%,高于肺部良性病变组(P <0.05).Ⅲ期、Ⅳ期肺癌 CEA 、Cy‐fra21‐1、SCC‐Ag 及 NSE 的平均含量显著高于Ⅱ期肺癌(P<0.01).将4项联合检验,对肺癌诊断的灵敏度上升到75.5%,高于4项单独检测时的灵敏度(P<0.01).结论将 CEA 、Cyfra21‐1、SCC‐Ag 、NSE 4项联合检测可提高肺癌的诊断率,有一定的临床价值.     

CEA、CYFRA21-1、NSE、CA125联合检测在肺癌诊断中的价值

目的 评价血清癌胚抗原（CEA）、细胞角蛋白19片段（CYFRA21-1）、神经元特异性烯醇化酶（NSE）、糖类抗原125（CA125）在肺癌诊断中的作用及其联合检测的临床价值.方法 选取500例肺癌患者,分为鳞癌、腺癌和小细胞癌3组,采用电化学发光法检测并分析各组间及和50例健康对照组血清CEA,CYFRA21-1,NSE,CA125水平.结果 肺癌组的各项肿瘤标志物水平较健康对照组差异具有统计学意义（P＜0.05）;腺癌组与鳞癌组比较中,CEA,CYFRA21-1差异具有统计学意义（P＜0.05）;小细胞癌组与鳞癌组比较中,CYFRA21-1,NSE差异具有统计学意义（P＜0.05）;小细胞癌组与腺癌组比较中,CEA,NSE差异具有统计学意义（P＜0.05）;4种肿瘤标志物联合检测肺癌敏感性为83％,高于任一肿瘤标志物单项检测.结论 4种肿瘤标志物在肺癌诊断、病理类型和临床分期中均有一定价值,其中CEA对肺腺癌,CYFRA21-1对肺鳞癌,NSE对肺小细胞癌诊断价值较高.肿瘤标志物联合检测有助于提高肺癌的诊断和肺癌高危人群的筛查.