NSE、CYFRA21-1及CEA检测在肺癌诊断中的价值

目的探讨三种肿瘤标志物联合检测在肺癌诊断中的价值。方法采用电化学发光免疫分析法检测86例肺癌患者（肺癌组）、52例结核性胸膜炎患者（结核组）胸腔积液和血清中神经元特异性烯醇化酶（NSE）、细胞角蛋白19片段（CYFRA21-1）及癌胚抗原（CEA）的水平,并与67例健康人（对照组）血清中上述指标比较。结果肺癌组胸腔积液及血清中的NSE、CYFRA21-1、CEA水平均显著高于结核组及对照组（P均〈0.01）。NSE在小细胞肺癌中的水平显著高于其他类型肺癌（P均〈0.01）,CYFRA21-1在肺鳞癌中的水平明显高于其他类型肺癌（P均〈0.01）。三项指标联合检测对不同病理类型肺癌诊断的敏感性均明显高于单项指标（P均〈0.01）。结论联合检测胸腔积液中上述三种肿瘤标志物水平可提高肺癌的检出率;NSE、CYFRA21-l有助于鉴别肺癌类型。

Value of the NSE, CYFRA21-1 and CEA examination in lung cancer diagnosis

Objective To investigate the value of combined examination of three kinds of tumor markers.Methods The neuronspecific enolase（NSE）,cell keratin 19 fragments（CYFRA21-1）and carcinoembryonic antigen（CEA）levels in pleural effusion and serum of 86 patients with lung cancer（lung cancer group）,52 patients with benign lung diseases（TB group） and 67 normal adults（control group）were measured by electro-chemi-luminescence immunoassay assay.Results The levels of NSE,CYFRA21-1 and CEA in pleural effusion and serum of the lung cancer group were all significantly higher than those of the TB group and control group（all P0.01）;the levels of NSE in patients with small-cell lung cancer were significantly higher than those in patients with the other subtypes of lung cancer,the levels of CYFRA21-1 in patients with squamous-cell carcinoma were significantly higher than those in patients with the other subtypes of lung cancer（all P0.01）.The sensitivity of the three kinds of tumor markers for diagnosing lung cancer was significantly enhanced when they were combined.Conclusion Combined examination of the aboved three kinds of tumor markers in pleural effusion can increase the diagnostic sensitivity for lung cancer.The examination of NSE and CYFRA21-1 is helpful for the differentiation of different subtype lung cancer.