联检血清CEA、NSE、CYFRA21-1水平对晚期肺癌疗效和预后的意义

目的：探讨血清CEA、NSE和CYFRA21-1在晚期肺癌疗效评价及预后判断中的价值。方法：68例接受一线化疗的晚期肺癌患者,于化疗前及第2个周期后分别检测血清CEA、NSE、CYFRA21-1水平,同时行影像学检查评价客观疗效以及进行生存随访。选择80例肺部良性疾病患者作为对照组,并检测其血清CEA、NSE、CYFRA21-1水平。结果：肺癌组血清CEA、NSE和CYFRA21-1浓度及阳性率均显著高于对照组;化疗有效者三者水平明显下降,病情稳定和进展者三者水平无变化或升高;化疗前血清CEA、CYFRA21-1水平高、低组的预后差异有统计学意义（P〈0.05、P〈0.001）,NSE水平高、低组的患者预后差异无统计学意义（P〉0.05）。结论：血清CEA、NSE、CYFRA21-1联检在晚期肺癌病情监测、疗效评价及预后判断等方面具有重要的临床价值。

Clinical Value of Combined Determination of Serum CEA, NSE and CYFRA21-1 Levels in the Assessment of Treatment Efficacy and Prognosis in Patients with Advanced Lung Cancer

Objective To investigate the value of combined determination of serum CEA,NSE and CYFRA21-1 levels in the assessment of treatment efficacy and prognosis in patients with advanced lung cancer.Methods The serum levels of CEA,NSE and CYFRA21-1 were measured with radio-immunoassay in 68 patients with advanced lung cancer before and after 2 cycles of firstline chemotherapy,as well as in 80 patients with benign lung disease as controls.Treatment efficacy was assessed based upon radiologic objective response.Results The concentrations and positive rates of serum CEA,NSE and CYFRA21-1 in lung cancer patients were significantly higher than those in patients with benign lung disease.After chemotherapy,the serum levels of the markers were decreased significantly in the PR patients,but increased or not changed in the PD or NC patients.The survival period of patients with initial high levels of CEA and CYFRA21-1 were significantly shorter than that of patients with initial low levels （P〈 0.01,P〈 0.001） .However,the initial NSE levels were not of prognostic significance （P〈 0.05） .Conclusion Combined detection of serum CEA,NSE,CYFRA21-1 levels can be useful for prediction of therapeutic efficacy and prognosis in patients with advanced lung cancer.