血清ProGRP、CEA、CYFRA211、NSE、CA199和AFP联合检测在肺癌诊断的临床价值

目的探讨联合检测血清肿瘤标志物胃泌素释放肽前体(ProGRP)、癌胚抗原(carcinoembryonic antigen，CEA)、细胞角蛋白19片段(cytokeratin 19 fragment，CYFRA211)、神经特异性烯醇化酶(neuron specific enolase，NSE)、糖类抗原199(carbohydrate antigen 199，CA199)和甲胎蛋白(alpha fetoprotein，AFP)在肺癌诊断中的价值。 方法收集2016年10月至2017年9月昆明市第三人民医院血清560例，其中280例为肺癌患者、180例肺部良性疾病患者和100例健康体检者，采用电化学发光法分别检测血清中6种肿瘤标志物的含量。 结果肺癌组5种肿瘤标志物(ProGRP、CYFRA211、NSE、CEA、CA199)水平均明显高于肺部良性疾病组和正常对照组，差异有统计学意义(χ²分别为401.251、25.475、35.292、37.491和13.472，P<0.01)。小细胞肺癌组、腺癌组和鳞癌组血清ProGRP、CYFRA211、NSE和CEA水平比较，差异有统计学意义(χ²分别为365.073、15.657、37.971和13.437，P<0.01)。ProGRP和NSE联合检验在小细胞肺癌中的灵敏度高达97.9%，CEA、CYFRA211和NSE联合检验在腺癌中的灵敏度达87.7%。 结论血清肿瘤标志物ProGRP、CEA、CYFRA211、NSE、CA199和AFP的联合检测对肺癌的诊断和疗效监测均具有较高的临床应用价值，联合检测可进一步提高敏感度和特异性。

Clinical value of combined detection of serum ProGRP,CEA, CYFRA211, NSE,CA199 and AFP in diagnosis of lung cancer

ObjectiveTo explore the value of serum tumor markers ProGRP, carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA211), neuron specific enolase (NSE), carbohydrate antigen 199 (CA199) and alpha fetoprotein (AFP) in diagnosis of lung cancer. MethodsSerum samples from 560 patients were collected in Third People′s Hospital of Kunming City during October 2016 to September 2017. Among them, 280 cases were lung cancer, 180 cases were benign lung disease and 100 cases were routine physical examination. The six tumor markers mentioned above in serum were detected by electrochemiluminescence immunoassay. ResultsThe levels of ProGRP, CYFRA211, NSE, CEA and CA199 in lung cancer group were significantly higher than those in benign lung disease group and normal control group (χ²=401.251, 25.475, 35.292, 37.491 and 13.472, P<0.01, respectively). The serum levels of ProGRP, CYFRA211, NSE and CEA in small cell lung cancer group, adenocarcinoma group and squamous cell cancer group were significantly different (χ²=365.073, 15.657, 37.971 and 13.437, P<0.01, respectively). The sensitivity of combined detection of ProGRP and NSE in small cell lung cancer is 97.9%. The sensitivity of combined detection of CEA, CYFRA211 and NSE in adenocarcinoma was 87.7%. ConclusionThe combined detection of serum tumor markers ProGRP, CEA, CYFRA211, NSE, CA199 and AFP has high clinical value for the diagnosis and monitoring of the curative effect of lung cancer. Combined detection of these markers can further improve the sensitivity and specificity.