血清NSE、CEA、CA125水平在小细胞肺癌患者诊断和疗效评估中的价值

目的探讨血清神经元特异性烯醇化酶(NSE)、癌胚抗原(CEA)、糖类抗原125(CA125)水平在小细胞肺癌(SCLC)患者诊断和疗效评估中的价值。方法选取郑州人民医院收治的SCLC患者(SCLC组)48例、非小细胞肺癌患者(NSCLC组)53例,另选取同期在我院体检的正常人作为对照组,分别检测各组血清NSE、CEA、CA125水平;SCLC患者检测化疗后1周、2周、4周的血清NSE、CEA、CA125水平。结果SCLC组NSE水平明显高于NSCLC组,CEA、CA125水平明显低于NSCLC组(P<0.05);ROC结果显示,NSE、CEA、CA125诊断SCLC的AUC分别为0.825、0.613、0.533,敏感度和特异度分别为77.1%、81.1%,58.3%、66%,89.6%、41.9%;不同TNM分期NSE的水平比较,Ⅳ期>Ⅲ期>Ⅱ期>Ⅰ期(P<0.05),CEA、CA125水平差异无统计学意义(P>0.05);治疗后NSE、CEA水平均明显低于治疗前,治疗后4周<治疗后2周<治疗后1周(P<0.05),CA125水平差异无统计学意义(P>0.05)。结论血清NSE可作为SCLC诊断和临床分期的一项重要肿瘤标志物,同时NSE、CEA对判断SCLC治疗疗效具有重要参考价值。而CA125则在SCLC诊断中特异度低,不适合作为SCLC的肿瘤标志物。

Value of serum NSE,CEA and CA125 levels in diagnosis and efficacy evaluation of patients with small cell lung cancer

Objective To explore the value of the serum neuron-specific enolase(NSE),carcinoembryonic antigen(CEA),and carbohydrate antigen 125(CA125)levels in the diagnosis and efficacy evaluation of patients with small cell lung cancer(SCLC).Methods Forty eight patients with SCLC(SCLC group)and 53 patients with non-small cell lung cancer(NSCLC group)admitted in People′s Hospital of Zhengzhou were selected,the normal subjects in physical examination in the hospital during the same period were separately selected and divided into the control group.The serum levels of NSE,CEA and CA125 of patients was tested in all groups respectively,and the serum levels of NSE,CEA and CA125 of SCLC patients in all groups in 1 week,2 weeks and 4 weeks after chemotherapy were tested.Results NSE level in the SCLC group was significantly higher than that in NSCLC group,and CEA and CA125 levels were significantly lower than NSCLC group(P<0.05).ROC results showed that AUC of NSE,CEA,and CA125 of the diagnosis of SCLC was 0.825,0.613,0.533,respectively,and the sensitivity and specificity were 77.1%,81.1%,58.3%,66%,89.6%,41.9%,respectively.Compared the level of NSE at different stage of TNM,it satisfied stageⅣ>stageⅢ>stageⅡ>stageⅠ(P<0.05).The difference in the level of CEA and CA125 was not significant(P>0.05);the level of NSE and CEA after treatment was significantly lower than that before treatment(P<0.05)(4 w<2 w<1 w),and the difference in the level of CA125 was not significant(P>0.05).Conclusion Serum NSE is eligible to be used as one important tumor marker for diagnosis and clinical staging of SCLC,NSE and CEA are of important reference value for efficacy of SCLC,while CA125 has low specificity in the diagnosis of SCLC and is not suitable as a tumor marker of SCLC.