血清CYFRA21-1、NSE和CEA在肺癌诊断和评估预后中的临床价值

目的 探讨血清肿瘤标志物细胞角蛋白片段21-1（CYFRA 21-1）、神经元特异性烯醇化酶（NSE）和癌胚抗原（CEA）在肺癌的早期诊断、肿瘤发展预测和预后判断方面的作用。方法 采用全自动电化学发光法对68例肺癌患者(肺癌组)、36例肺部良性病变患者（肺良性病组）和28例健康志愿者（健康组）进行血清CYFRA 21-1、NSE和CEA水平的检测，并分析CYFRA 21-1、NSE和CEA与肺癌TNM分期的相关性；采用Kaplan-Meier曲线分析患者生存期与CYFRA 21-1、NSE 和 CEA水平的关系。结果 与肺良性病组和健康组相比，肺癌组血清CYFRA21-1、NSE和CEA水平明显升高（P<0.01），非小细胞肺癌的CYFRA21-1敏感度最高（78.72%），小细胞肺癌NSE敏感度最高（91.23%），与TMN分期呈明显正相关性（P<0.01），与生存期呈明显负相关性（P<0.01）。结论 肺癌患者血清中CYFRA21-1、NSE和CEA水平均明显升高，提示该三项指标有望成为肺癌早期诊断、肿瘤发展预测和预后判断的重要生物学指标。

Clinical value of serum CYFRA 21-1, NSE and CEA in the diagnosis and prognosis of lung cancer

ObjectiveTo investigate the clinical significance of serum cytokeratin 19 fragments (CYFRA 21-1), neuron specific enolase ( NSE) and carcinoembryonic antigen (CEA) in the diagnosis and prognosis of lung cancer． Methods Serum CYFRA21-1, NSE and CEA were measured with chromatometrychemoluminescence method in 68 patients with lung cancer at different TNM stages(the lung cancer group)， 36 patients with benign lung diseases( the lung benign group)， and 28 healthy people(the healthy group), and the relationship of CYFRA21-1, NSE and CEA with TNM stages were analyzed． Survival curves were estimated to analyze the relationship of CYFRA21-1, NSE and CEA with survival time using Kaplan-Meier analysis. Results Serum levels of CYFRA 21 1, NSE and CEA were significantly higher in the lung cancer group than in lung benign and healthy groups(both P<0.01). There were positive relations of CYFRA 21-1, NSE and CEA with the TNM stage, and negative relations with survival time（P<0.01）. CYFRA21-1 had the highest sensitivity(78.72%) in non-small cell lung cancer, and NSE had the highest sensitivity(91.23%)in small cell lung cancer. Conclusion Serum levels of CYFRA 21-1, NSE and CEA are significantly raised in patients with lung cancer， which suggests that they are important markers for the early diagnosis, development and prognosis of lung cancer．