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。

Combination of IGF-1,CEA,CYFRA21-1,NSE,CA199 diagnosis and prediction of treatment response in lung cancer

Objective To evaluate tumor markers of insulin-like IGF-1,CEA,CYFRA21-1,NSE,CAl99for the diagnosis of lung cancer.cancer.Methods The levels of IGF-1,CEA,CYFRA21-1,NSE,CAl99were assayed and compared between the lung cancer group（98cases）,benign pulmonary group（46cases）,healthy group（42cases）.Results The levels of five serum tumor markers in the lung cancer group were higher than those in benign pulmonary group and healthy group.These differences were all statistically significant（P＆lt;0.05）.The levels of five tumor markers in lung cancer patients after treatment were lower than those before treatment.These differences were all statistically significant（P＆lt;0.05）.The levels of five serum tumor markers inⅢ/Ⅳlung cancer patients were higher than those inⅠ/Ⅱlung cancer patients.These differences were all statistically significant（P＆lt;0.05）.The levels of CEA in the adenocarcinoma was higher than those in the squamous cell carcinoma and small cell carcinoma,the levels of NSE in the small cell carcinoma was higher than those in the squamous cell carcinoma and adenocarcinoma,the levels of CYFRA21-1in the squamous cell carcinomas was higher than those in themall cell carcinoma and adenocarcinoma,these differences were all statistically significant（P＆lt;0.05）.The joint detection of five serum tumor markers in lung cancer was up to 0.986.Conclusion Tumor markers showed some differences in the development of lung disease process,therefore detection of multi-serological index has important pratical value for diagnosis,staging and predicting prognosis of lung cancer.