肺癌患者血浆D-二聚体、NSE及CYFRA21-1联合检测的临床价值

探讨血浆D-二聚体和神经元特异性烯醇化酶、细胞角蛋白19片段21-1联合检测在肺癌诊断中的临床价值。方法 选取2016年2月~2017年12月我院收治的130例肺癌患者作为肺癌组，同时选取40例肺部良性肿瘤患者（良性病变组）及40例同期体检健康者（健康对照组）为对照，采用化学发光法检测血清NSE、CYFRA21-1，血浆D-二聚体检测采用免疫比浊法分别检测各组血浆D-D、血清NSE和CYFRA21-1水平，并对结果进行分析。结果 肺癌组血浆D-D、血清NSE和CYFRA21-1水平均高于肺部良性病变组及健康对照组（P＜0.05）；三项指标与肺癌的恶性程度相关，肺癌分期Ⅲ~Ⅳ期患者血浆D-D、血清NSE和CYFRA21-1水平高于Ⅰ~Ⅱ期患者（P＜0.05）；血浆D-D、血清NSE和CYFRA21-1在肺癌中的敏感度分别为68.31%、54.44%及52.22%，其三项联合检测的敏感度为88.89%。结论 肺癌患者血浆D-D、血清NSE和CYFRA21-1水平升高，对肺癌的临床分期具有一定鉴别诊断作用，可以作为肺癌诊断的敏感指标。三项联合检测对肺癌的早期辅助诊断具有重要的临床价值。

Clinical Value of the Plasma D-dimer and Serum NSE,CYFRA21-1 Combined Detection in the Diagnosis of Lung Cancer

Objective To evaluate the plasma D-dimer(D-D) and serum neuronspecific enolase(NSE), Cytokeratin 19 fragment21-1 (CYFRA21-1) combined detection in the diagnosis of lung cancer．Methods 130 cases of lung cancer were selected admitted to our hospital from February 2016 to December 2017 as the research object (lung cancer group), At the same time, 40 patients with benign lung cancer (benign lesion group) and 40 patients (healthy control group) were selected as the control. The levels of D-D,NSE and CYFRA21-1 in all subjects were detected and the results were analyzed. Results Plasma D-D, serum NSE and CYFRA21-1 in the lung cancer group were significantly higher than those in the lung benign lesion group and the healthy control group (P＜0.05).Three indicators were associated with the malignant degree of lung cancer. The levels of plasma D-D,serum NSE and CYFRA21-1 at stage Ⅲ/Ⅳ were higher than those at stageⅠ/Ⅱ(P＜0.05). The sensitivity of plasma D-D,serum NSE and CYFRA21-1 in the diagnosis of lung cancer was 68.31%, 54.44% and 52.22%, but the combined sensitivity was 88.89%.Conclusion The levels of plasma D-D, serum NSE and CYFRA21-1 in lung cancer patients were significantly increased, and the clinical staging of lung cancer had a certain differential diagnosis role, which could be used as a sensitive indicator for the diagnosis of lung cancer. The combined detection of plasma D-D,serum NSE and CYFRA21-1 plays an important role in the diagnosis of lung cancer.