几种常用的肿瘤标志物在肺癌诊治中的应用价值

目的探讨癌胚抗原(carcinoembrynic antigen,CEA)、糖链抗原125(carbohydrate antigen,CA125)、糖链抗原50(carbohydrate antigen,CA50)、β2-微球蛋白(carbohydrate antigen,β2-MG)、神经元特异性烯醇化酶(neuron-specific enolase,NSE)、细胞角质蛋白19片段(cytokeratin fragmen19,CYFRA21-1)在肺癌诊断及疗效判断中的应用价值。方法采用Elecsys 2010电化学发光仪检测85例肺癌患者、62例肺部良性疾病患者、28例健康人血清中6种肿瘤标志物的水平。结果 CEA、CA125、CA50、β2-MG、NSE、CYFRA21-1 6种标志物在肺癌患者中的含量均显著增高,明显高于肺部良性疾病组和健康对照组,差异具有统计学意义(P<0.01)。CEA、CYFRA21-1、NSE、CA125、CA50治疗前后差异有统计学意义。β2-MG在治疗前后差异无统计学意义。CYFRA21-1在鳞癌中的水平最高,明显高于其他类型的肺癌,差异具有统计学意义(P<0.05);NSE在小细胞肺癌中水平高于其他类型,差异具有统计学意义(P<0.05),CA125在腺癌中水平明显高于其他类型,差异具有统计学意义(P<0.05);CEA、CA50、β2-MG3种标志物在4种类型肺癌中的水平均明显升高,差异无统计学意义(P>0.05)。结论 CY-FRA21-1、CA125、NSE、CEA联合检测可以提高肺癌的早期诊断率并可以用于评价疗效;CYFRA21-1、CA125、NSE具有良好的组织学特异性,可以鉴别不同病理类型的肺癌。

Diagnostic and therapeutic value of some common serum tumor markers for lung cancer

Objective To evaluate the application value of CEA,CA125,CA50,β2-MG,NSE and CYFRA21-1 used alone or in combination for the diagnosis of lung cancer.Methods The serum levels of six tumor markers CEA,CA125,CA50,β2-MG,NSE and CYFRA21-1 were detected by Elecsys 2010 electrochemiluminescence analysator in 85 patients with lung cancer,62 patients with benign lung disease（BLD） and 28 healthy adults.Results The serum levels of the six tumor markers were significantly higher in lung cancer patients than in benign intestinal patients and healthy adults（P0.01）.In the patients after lung cancer operation,the serum levels of CEA,CYFRA21-1,CA125 and CA50 were significantly lower（P0.01）.Although with higher levels in lung tumors,no statistical difference in serum levels of CEA,CA50 and β2-MG was found in the four different tumor types.The expression of CYFRA21-1 in squamous cancer was higher than that in the three other types of tumors（P0.05）.NSE expressed highest in small cell lung cancer（P0.01）,while CA125 expressed highest in adenocarcinoma（P0.01）.Conclusion The six tumor markers can be good indices for early diagnosis of lung cancer,and combined detection of CYFRA21-1＋CA125＋NSE will be better for the diagnosis and treatment of lung cancer.