Clinical evaluation of combination assay of tumor markers in primary lung cancer patients

Recently, the measurement of tumor markers, particularly for combined measurement, have been reported to be useful for the early diagnosis of cancer. In this study, the authors measured the serum levels of SLX, CA19-9, CA153, CA125, NCC-ST-439, CEA, SCC, NSE, TPA and IAP in 155 patients with primary lung cancer before treatment (76 adenocarcinomas, 40 squamous cell carcinomas, 36 small cell cancers, 3 large cell cancers). Seventy three benign lung disease cases were also studied as controls. The serum levels of CA19-9, CA153, CA125, NCC-ST-439, CEA, NSE and TPA were significantly higher in lung cancer patients than in benign lung disease patients. CA125 and CEA levels in adenocarcinoma, SCC levels in squamous cell carcinoma, NSE levels in small cell cancer and NCC-ST-439 in non-small cell cancer were significantly higher than those of other histological types of cancer. The level of each marker became higher, and was related with advance in stage. The probability of lung cancer was 90% when three markers were positive except for IAP, which was frequently false positive in benign lung disease. In conclusion, the simultaneous, combined measurement of at least three markers, including CEA and/or TPA was considered to be useful for the diagnosis of lung cancer.     

Diagnostic utility of serum and pleural fluid carcinoembryonic antigen, neuron-specific enolase, and cytokeratin 19 fragments in patients with effusions from primary lung cancer

STUDY OBJECTIVES: To assess the diagnostic values of carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), and cytokeratin 19 fragments (CYFRA 21-1) as markers of pleurisy in primary lung cancer. DESIGN: Prospective case-control study. SETTING: A tertiary university hospital. PATIENTS: Thirty-four patients with lung cancer and 16 patients with tuberculous pleurisy. MEASUREMENTS AND RESULTS: Levels of CEA, NSE, and CYFRA 21-1 were measured by immunoassay in the serum and pleural fluid of patients with lung cancer and of patients with tuberculous pleurisy. Patients with lung cancer were found to have significantly higher serum and pleural fluid levels of CEA and CYFRA 21-1 than patients with tuberculous pleurisy. Using cutoff values of 5 ng/mL, 20 ng/mL, and 3.3 ng/mL for serum CEA, NSE, and CYFRA 21-1, respectively, the sensitivities and specificities of these tumor markers were as follows for differentiating malignant effusion from benign: CEA, 68% and 93%; NSE, 34% and 93%; and CYFRA 21-1, 45% and 100%. Using cutoff values of 5 ng/mL, 20 ng/mL, and 45 ng/mL for pleural fluid, the sensitivities and specificities were as follows: CEA, 82% and 94%; NSE, 36% and 94%; and CYFRA 21-1, 61% and 81%. A combination of pleural fluid CEA and NSE increased sensitivity and specificity. CONCLUSIONS: In the diagnosis of malignant effusion associated with lung cancer, the determinations of CEA and NSE in pleural fluid could enhance diagnostic yield better than those of all three tumor markers.     

肺癌患者异常糖链糖蛋白与传统肿瘤标志物的相关性分析

目的通过回顾性分析肺癌患者异常糖链糖蛋白(TAP)水平以及传统肿瘤标志物癌胚抗原(CEA)、鳞状细胞癌抗原(SCC)、糖类抗原125(CA125)、神经元特异性烯醇化酶(NSE)和细胞角蛋白19片段(CYFRA21-1)水平,探讨肺癌患者TAP与传统肿瘤标志物之间的相互关系。 方法分别采用凝聚素亲和法及电化学发光免疫分析法检测我院呼吸内科经治的181例肺癌患者TAP和5种血清学肿瘤标志物的水平,对所得TAP与5种血清学肿瘤标志物的数据进行spearman相关性检验分析。 结果肺癌患者TAP与CEA呈正相关(P＝0.016),而与SCC、CA125、NSE及CYFRA21-1之间没有相关性(P值均>0.05);亚组分析,腺癌、鳞癌患者的TAP与CEA均呈正相关(P值分别为0.021,0.044),腺癌、鳞癌、小细胞癌及未分类癌患者的TAP与CA125均呈正相关(P值分别0.046,0.007,0.001,0.006),而这四类癌的TAP与SCC、NSE和CYFRA21-1之间没有明显相关性(P值均>0.05)。 结论肺癌患者TAP值是CEA、CA125等多种肿瘤异常蛋白水平的综合体现,尤其在肺腺癌患者中与传统肿瘤标志物具有较好的正相关性。     

肺癌患者自身抗体与肿瘤标志物相关性分析

目的探讨肺癌自身抗体与肿瘤标志物之间的相互关系。方法收集2016年9月至2016年12月收治于第四军医大学唐都医院呼吸内科的肺癌患者112例,分别采用酶联免疫吸附实验法和电化学发光免疫分析法检测肺癌患者7种自身抗体和5种血清学肿瘤标志物的水平,对所得患者自身抗体P53、PGP9.5、SOX2、GAGE7、GBU4-5、MAGE和CAGE,以及肿瘤标志物CEA、SCC、CA125、NSE和CYFRA21-1,的数据进行spearman相关性检验分析。结果不同病理类型肺癌患者的自身抗体水平,肺腺癌患者GAGE7中位数为7.30 U/ml,明显高于鳞癌、小细胞癌等其他类型的肺癌患者(P=0.041),而P53、PGP9.5、SOX2、GBU4-5、MAGE和CAGE水平则无统计学差异。传统的肿瘤标志物CEA和CA125在肺腺癌中、SCC在肺鳞癌中明显升高(P值均0.05)。经spearman相关性检验分析,在肺癌中,P53与CEA、SCC呈正相关(P值分别为0.024,0.016),PGP9.5与NSE呈正相关(P0.001),GBU4-5与SCC、CA199呈正相关(P值分别0.001,=0.011),MAGE与SCC、CA199呈正相关(P值分别=0.004,0.001)。结论肺癌患者自身抗体与肿瘤标志物存在正相关,同时检测二者可相互补充,更益于肺癌的及时诊断。     

Twist蛋白、VEGF、CEA、CYFRA21-1、NSE在肺癌患者恶性胸水中的表达和应用

目的：探讨肺癌患者恶性胸水中Twist蛋白、血管内皮生长因子(VEGF)、癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)、神经原特异性烯醇化酶(NSE)的表达及其临床意义。方法采集52例肺癌患者恶性胸腔积液标本,其中腺癌24例,鳞癌16例,小细胞肺癌12例,良性胸腔积液患者45例作为对照。应用酶联免疫吸附试验法和化学发光法检测各指标水平。结果肺癌组恶性胸水中 Twist 蛋白、VEGF、CEA、CYFRA21-1、NSE 的表达均高于良性肺病组(t值分别为8.67、9.11、3.94、5.37、3.10,P值均<0.05);肺癌组恶性胸水中 Twist 和 VEGF的水平与患者肿瘤病理类型无关(P 值均>0.05),CEA 水平在腺癌中最高,CYFRA21-1水平在鳞癌中最高,NSE水平在小细胞肺癌中最高。Twist 蛋白、VEGF、CEA、CYFRA21-1、NSE 在肺癌恶性胸水中的敏感度分别为78.8%、84.6%、61.5%、46.2%、42.3%,特异度分别为86.7%、88.9%、91.1%、86.7%、77.8%。CEA、CYFRA21-1、NSE在不同肺癌恶性胸水中敏感度不同,联合检测可提高敏感度。结论胸水中 Twist 蛋白、VEGF、CEA、CYFRA21-1、NSE 检测有利于良、恶性胸水的鉴别, Twist蛋白、VEGF水平与肿瘤病理类型无关,CEA、CYFRA21-1、NSE 水平与肿瘤病理类型相关,联合检测可提高诊断的敏感度。     

血清CEA、SCC、CYFRA21—1、ProGRP联合检测在肺癌诊断中的价值

目的 探讨血清癌胚抗原（CEA）、鳞状细胞癌抗原（SCC）、细胞角蛋白19片段（CYFRA21-1）、胃泌素释放肽前体（ProGRP）联合检测在肺癌诊断中的价值。方法 选取2011年3月至2013年8月我院收治的60例已经确诊的肺癌患者,将其作为临床研究对象（实验组）,另选取60例良性肺病患者作为对照（对照组）,采用酶联免疫分析法检测两组患者的血清CEA、SCC、ProGRP水平,并用电化学发光法测定CYFRA21-1水平,对CEA、SCC、CYFRA21-1和ProGRP 4种肿瘤标志物的阳性率与水平进行比较。结果 实验组血清CEA、SCC、CYFRA21-1和ProGRP 4种肿瘤标志物的阳性率分别为53.3%、21.7%、41.7%、10.0%,对照组血清CEA、SCC、CYFRA21-1和ProGRP 4种肿瘤标志物的阳性率分别为10.0%、15.0%、8.3%、1.7%。实验组血清CEA、SCC、CYFRA21-1和ProGRP的阳性率均明显高于对照组,P〈0.05;实验组血清CEA、SCC、CYFRA21-1和ProGRP 4种肿瘤标志物的水平分别为20.1±2.3、1.0±0.5、8.5±1.6、179.5±37.8,对照组血清CEA、SCC、CYFRA21-1和ProGRP 4种肿瘤标志物的水平分别为3.5±2.1、0.8±0.4、1.1±0.7、4.5±0.6。实验组的血清CEA、SCC、CYFRA21-1和ProGRP水平均明显高于对照组,P〈0.05。结论 采用血清CEA、SCC、CYFRA21-1和ProGRP联合检测可以提高肺癌的诊断效率,对肺癌诊断有很大的临床价值,为患者的疾病治疗争取到了时间,值得在临床大力推广应用。     

CEA、CYFRA21-1、NSE、LDH在良恶性胸腔积液中的鉴别诊断价值

目的 探讨血清及胸腔积液中癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)、神经特异性烯醇化酶(NSE)、乳酸脱氢酶(LDH)在良恶性胸腔积液鉴别诊断价值.方法 分析我院55例肺癌患者和53例良性胸腔积液患者的血清及胸腔积液中CEA、CYFRA21-1、NSE、LDH检测水平,并根据受试者工作特性(ROC)曲线建立合理的临床判断临界值及检测的敏感性和特异性.结果 恶性患者胸水CYFRA21-1、NSE、CEA、LDH的水平高于良性患者(P<0.05).胸水CEA、CYFRA21-1、NSE、LDH的敏感性和特异性分别为90.9、63.6、72.7、36.4%和98.1、83、67.9、88.7%.血清CEA、CYFRA21-1、NSE、LDH的敏感性和特异性分别为89.1、87.3 、32.1、25.5%和92.5、79.2、90.6、92.5%.结论 胸水中CYFRA21-1、NSE、CEA、LDH检测在良恶性胸腔积液鉴别诊断中具有一定临床价值.     

肿瘤标志物在肺癌诊断、病理分型和临床分期中的价值

目的研究血清肿瘤相关抗原125（CA125）、199（CA199）、癌胚抗原（CEA）、神经元特异性烯醇化酶（NSE）、细胞角蛋白19片段（CYFRA21—1）在肺癌诊断、病理分型和临床分期中的价值。方法选取郑州大学第一附属医院2011年6月至2012年9月入院患者309例血清标本,采用电化学免疫荧光发光法检测血清肿瘤标志物的浓度。结果肺癌患者5种血清肿瘤标志物水平均高于肺部良性病变组。单项检测,腺癌、鳞癌、小细胞肺癌（SCCL）敏感度最高者分别为CYFRA21—1和CEA、CYFRA21—1、NSE。联合检测CA125＋CEA＋NSE＋CYFRA21—1敏感度达87．26％。CA125、CEA、CYFRA21—1在肺癌不同TNM分期的表达阳性率及表达高度不同。结论血清5种肿瘤标志物诊断肺癌价值较高,其中CYFRA21—1诊断价值最大,联合检测可以提高肺癌诊断敏感度。CA125、CEA、CYFRA21—1在肺癌临床分期中价值较大。     

血清肿瘤标志物与肺癌的关系

目的探讨血清肿瘤标志物与肺癌的关系;方法取确诊肺癌患者治疗前后血清测定CEA、CAl25、NSE、CYFRA21—1、AFP、CA19-9、CAl5-3、CA724、SCC;与非肺癌患者对照,采用多组均数的非参数检验（krus—wallis检验）、T检验;结果在腺癌患者CEA、CA15-3水平最高;NSE、CA19-9在小细胞癌患者水平最高;CYFRA21—1在鳞癌最高;CA724在大细胞癌中最高（P〈0．01）;与非肺癌患者具有显著差异的是CEA、NSE、CYFRA21—1、CA19-9、CA15-3、CA724（P〈0．01）。血清肿瘤标志物治疗前后差异没有显著性;结论血清肿瘤标志物CEA、CA15-3、NSE、CA19-9、CYFRA21—1、CA724对一些肺癌的诊断有意义。     

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。     

联合检测肿瘤标记物在肺癌中的临床意义

目的 探讨血清CEA、CA19-9、CA125、CYFRA21-1、TSGF、NSE的联合检测在肺癌的临床诊断、病理分型、肿瘤分期中的临床意义.方法 联合检测122例原发性肺癌完全切除的患者肿瘤标记物的水平.结果 CEA在腺癌中升高较其他明显,CYFRA21-1在鳞癌及腺鳞癌中升高较其他明显,NSE在小细胞癌中升高较其他明显.联合检测在鳞癌敏感性最高,细支气管肺泡癌敏感性最低.结论 血清CEA、CA19-9、CA125、CYFRA21-1、TSGF、NSE的联合检测在肺癌的临床诊断、病理分型、肿瘤分期中具有一定意义.     

肿瘤标志物动态变化在肺癌疗效判断与随访中的意义

目的探讨癌胚抗原(carcino-embryonic antigen,CEA)、铁蛋白(ferritin,FRT)、糖类抗原125(carbohydrate antigen 125,CA125)、神经元特异性烯醇化酶(neuron specific enolase,NSE)和细胞角蛋19片段(cytokeratin19 fragment,CYFRA21-1)等5种血清学肿瘤标志物(tumor markers,TM)的动态变化在肺癌疗效判断与随访中的意义。方法选择唐都医院呼吸内科经治的170例中晚期肺癌患者,采用电化学发光免疫分析法检测CEA、FRT、CA125、NSE和CYFRA21-1等5种血清学TM,观察不同TM在肺癌治疗过程中的动态变化水平。结果治疗2周期后,CA125在各肺癌组、CYFRA21-1在鳞癌和腺癌及未分类癌、NSE在小细胞癌及神经内分泌癌、CEA在腺癌和未分类癌及神经内分泌癌、FRT在鳞癌治疗中呈下降趋势。结论血清TM水平的动态变化,在一定程度上反映肿瘤的活动情况及疗效,可用于肺癌疗效判断与随访。     

胸水、血清中CEA、NSE、CYFRA21-1对恶性胸腔积液的诊断价值

目的探讨胸水、血清中CEA、NSE、CYFRA21-1对恶性胸腔积液的诊断价值。方法测定40例恶性胸水和40例非恶性胸水及其血清中CEA、NSE、CYFRA21—1的水平。结果恶性胸水组胸水及其血清中CEA、NSE、CYFRA21-1的水平明显高于非恶性胸水组,有显著性差异（P〈0．05）。恶性胸水组3项联合检测的阳性率明显高于单项检测（P〈0．05）。结论联合检测胸水及其血清中CEA、NSE、CYFRA21-1对鉴别良、恶性胸水有一定的临床价值。     

Serological studies on CEA, CA 19-9, STn and SLX in colorectal cancer.

BACKGROUND/AIMS: Sialyl Le(x) (NeuAca2-3Galb1-4(Fuca1-3)GlcNAc1-R) (SLX) was introduced as cancer-associated. In this study, serological expression of SLX was examined with that of carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA 19-9) and sialyl Tn antigen (STn) concerning the prognosis and clinicopathological findings of patients with colorectal carcinoma. METHODOLOGY: One hundred and seventeen patients were operated on for colorectal cancer and were enrolled in this study. Serum CEA, CA 19-9, STn and SLX levels were measured pre-operatively by radioimmunoassays and the cut-off values were 5ng/ml, 37U/ml, 45U/ml, and 38U/ml, respectively. RESULTS: Serologically, the positive rates of CEA, CA 19-9, STn and SLX antigens were 33.3, 26.5, 23.1, and 17.1%, respectively. The CEA, CA 19-9 and SLX are stage specific in clinical stage. In the CEA, CA 19-9, STn, SLX-positive patients, 5-year survival rates were 41.0, 29.7, 50.1, and 29.1%, respectively. In the tumor marker-positive patients, prognosis was significantly poorer than in the negative patients. In the patients with Curability A or B, the difference in survival between the SLX-positive and negative patients was significant. Multivariate analysis revealed that significant prognostic indicators were accompanying liver metastasis, histological type, depth of invasion, CEA and SLX. CONCLUSIONS: The combination assay of serum CEA, CA 19-9, STn and SLX will be beneficial for diagnosis and follow-up of colorectal cancer.     

肺泡灌洗液和血清中肿瘤标志物检测在肺癌诊断中的价值

目的探讨支气管肺泡灌洗液与血清中肿瘤标志物检测在肺癌的临床诊断价值。方法测定患者支气管肺泡灌洗液与血清中的癌胚抗原(CEA)、鳞状细胞癌相关抗原(SCC)和神经元特异性烯醇化酶(NSE)以及可溶性细胞角蛋白19片段(CYFRA21-1)的含量。结果研究组血清和支气管肺泡灌洗液中CEA、SCC和NSE以及CYFRA21-1含量均明显高于对照组(P0.05)。支气管肺泡灌洗液与血清中不同病理类型和不同临床分期患者的CEA、SCC和NSE以及CYFRA21-1比较有统计学意义(P0.05)。结论检测支气管肺泡灌洗液中的肿瘤标志物对肺癌的诊断效果明显的由于检测血清中的肿瘤标志物诊断效果,对患者的病情程度和预后均具有一定的临床应用价值。     

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)     

肿瘤标志物CEA、CYFRA21-1和NSE联合检测对老年人胸腔积液鉴别诊断的意义

目的评价老年良、恶性胸腔积液患者血清和胸液中3种肿瘤标志物单项和联合检测的诊断价值。方法采集有胸腔积液患者的血清及胸水样本各64例，其中恶性组34例，良性组30例，用放射免疫法检测其血清及胸水癌胚抗原（CEA）、细胞角蛋白19片断（CYFRA21—1）和神经元特异性烯醇化酶（NSE）的含量。结果恶性组血清和胸水中CEA、CYFRA21—1、NSE水平均显著高于良性组（P〈0．01）；血清中3项指标对恶性胸水诊断的敏感性和特异性：CEA为79．4％和86．7％；CYFRA21—1为79．4％和83．3％；NSE为70．6％和73．3％；胸水中3项指标对恶性胸水诊断的敏感性和特异性：CEA为82．4％和83．3％；CYFRA21—1为79．4％和80．0％；NSE为64．7％和70．0％；CYFRA21—1与CEA联合检测可使血清标志物敏感性和诊断符合率提高至97．1％和92．2％，胸水标志物提高至97．1％和90．6％；血清和胸水中3种肿瘤标志物平行联合检测可提高诊断的敏感性至100％，系列联合检测可使特异性提高至100％。结论肿瘤标志物CEA、CYFRA21—1和NSE的联合检测，对老年人胸腔积液的鉴别诊断有较高的临床价值，以CEA＋CYFRA21—1组合为佳。     

四种肿瘤标志物血清水平的联合检测对肺癌诊断的临床价值

目的探讨血清肿瘤标志物细胞角蛋白19片段（CYFRA21-1）、神经元特异性烯醇化酶（NSE）、癌胚抗原（CEA）、糖类抗原125（CA125）联合检测对肺癌诊断的临床价值。方法采用瑞士罗氏公司cobas e 411型全自动电化学发光免疫分析系统检测经病理确诊的52例肺癌患者、30例肺部良性疾病患者及35例正常人血清CYFRA21-1、NSE、CEA、CA125水平,并计算阳性率、特异度及准确度。结果肺癌组血清4种肿瘤标志物水平显著高于肺良性疾病及健康对照组。其中单项检测CYFRA21-1阳性率以鳞癌最高（70.8%）,NSE阳性率以小细胞肺癌最高（75.0%）,CEA阳性率以腺癌最高（65.0%）,与其他型肺癌相比差异有统计意义。4种肿瘤标志物联合检测阳性率、特异度及准确度明显高于单项检测结果。结论 4种肿瘤标志物对于肺癌的辅助诊断均具有实用价值,且联合检测有助于提高肺癌诊断的阳性率、特异度及准确度。     

Prognostic value of serum tumor markers in patients with lung cancer

BACKGROUND: The role of tumor markers in the diagnosis and prognosis of lung cancer is under investigation. OBJECTIVES: The aim of this study was to investigate the diagnostic and prognostic significance of pre-therapeutic levels of various serum tumor markers, CYFRA 21-1, neuron-specific enolase (NSE), tissue polypeptide antigen (TPA), carcinoembryonic antigen (CEA), CA 125 and squamous cell carcinoma antigen (SCCAg), in patients with lung cancer. METHODS: We studied 102 consecutive patients (mean age 65.2 +/- 11 years) with newly diagnosed lung cancer (96 males, 94%, with a mean age of 66.3 +/-10.5 years). All patients had a 5-year follow-up. Measurements of the serum tumor markers were performed on initial diagnosis. RESULTS: Eighty-four patients (82%) had non-small-cell lung cancer (NSCLC) and 18 (18%) small-cell lung cancer (SCLC). From the 84 patients with NSCLC, 34 patients (33%) had squamous-cell lung cancer, 23 (22%) adenocarcinoma and 23 (22%) large-cell carcinomas. The overall median survival was 8.5 months. All SCLC patients had extensive disease with a median survival of 10.1 months and NSCLC patients of 8.4 months. Significant differences in the mean values of NSE and CYFRA 21-1 were observed between SCLC and NSCLC. In NSCLC, CYFRA 21-1, TPA, CA 125 and SCCAg serum levels were related to the stage of the disease at diagnosis, and CYFRA 21-1, NSE, TPA and CA-125 were related to a poor outcome. None of the above tumor markers was related to survival in the SCLC group. CONCLUSION: CYFRA 21-1 and NSE may help to differentiate cell types in lung cancer patients. Also, CYFRA 21-1 with TPA and CA 125 may provide useful information regarding the staging of the disease at diagnosis and the prognosis of patients with NSCLC.     

肺癌患者血清和胸水中常用肿瘤标志物的检测

目的探讨肺癌患者血清和胸水中6种肿瘤标志物的检测意义，并选择较理想的肿瘤标志物组合。方法应用ELISA检测120例肺癌患者和90例肺部良性疾病患者血清和胸水中以及50例健康人血清中神经元特异性烯醇化酶（NSE）、胃泌素释放肽前体（pro-GRP）、细胞角质蛋白19（CYFRA21-1）、鳞癌抗原（SCC）、p53抗体和癌胚抗原（CEA）的水平含量。结果肺癌患者血清和胸水6种肿瘤标志物水平均明显高于健康人组和肺部良性疾病组（P〈0．01）。肺部良性疾病组胸水中NSE、CYFRA21—1和CEA的假阳性率较高。血清NSE、pro—GRP在小细胞肺癌中的水平和敏感性明显高于其他类型的肺癌（P〈0．01）；血清CYFRA21-1、SCC在肺鳞癌中的水平和敏感性明显高于其他类型的肺癌（P〈0．01）。6种血清肿瘤标志物经组合后，在特异性下降不大的情况下。敏感性明显高于任一单项肿瘤标志物（P〈0．01）。结论6种肿瘤标志物的检测对于肺癌的辅助诊断有一定的临床意义。血清NSE、pro-GRP可作为联合检测小细胞肺癌的标志物组合；血清CYFRA21-1、SCC可作为联合检测肺鳞癌的标志物组合；血清NSE、CYFRA21-1、CEA可作为联合检测非小细胞肺癌的标志物组合。