血清 HE4与CYFRA21-1，NSE联合检测在肺癌诊断中的价值

目的：研究人附睾蛋白4（HE4）、细胞角蛋白19片段（CYFRA21‐1），糖分解烯醇酶（NSE）联合检测对肺癌的诊断价值。方法选取在2015年1～12月收集的370例肺癌患者，肺癌患者中包括小细胞癌、腺癌、鳞癌3类；以50健康人血清以及107例肺良性疾病患者对照组患者进行对比研究，包括肿瘤标志物检测水平比较、血清肿瘤标志物在各类型肺癌患者中阳性率比较、3种肿瘤标志物对肺癌诊断的灵敏性和特异性比较。结果肺癌组 HE4、CYFRA21‐1、NSE在肺癌患者中的含量都较高，与肺良疾病组及健康对照组对比，有显著的统计学差异（P＜0．05）；在 HE4检测中，鳞癌阳性检出率最高83．5％；CYFRA21‐1中，鳞癌阳性检出率最高62．5％；NSE检测中，小细胞肺癌的阳性检出率最高；肿瘤标志物中 HE474．42％、CYFRA21‐147．3％、NSE 42．16％，说明单项使用这些指标进行检测的阳性率均不高。三项联合检测的敏感性为79．72％，特异性为91．08％。结论血清HE4与CYFRA21‐1，NSE联合检测灵敏度和特异性都较高，所以适合在肺癌初期作为诊断的标志物进行联合检测。

HE4 and CYFRA21-1,NSE joint detection value in the diagnosis of lung cancer

Objective Human epididymis protein 4(HE4)and cytokeratin 19 fragment(CYFRA21‐1) ,glycolysis enolase(NSE) joint detection value in the diagnosis of lung cancer .Methods Selected from January to December in 2015 collection of 370 cases of patients with lung cancer ,lung cancer patients including small cell carcinoma ,adenocarcinoma and squamous carcinoma three catego‐ries;In 50 healthy individuals and 107 patients with lung benign disease control group patients serum comparison research ,including tumor markers detection level comparison ,serum tumor markers in various types of positive rate comparison ,the three tumor mark‐ers in patients with lung cancer to the sensitivity and specificity to diagnosis of lung cancer .Results The lung cancer group HE4 , CYFRA21‐1 ,NSE content is higher in the patients with lung cancer and lung benign disease group and health control group ,the differences were statistically significant (P< 0 .05);Positive rate in HE4 test ,squamous cell carcinomas was highest 83 .5% ;Posi‐tive rate CYFRA21‐1 ,squamous cell carcinomas was highest 62 .5% ;NSE detection ,the positive rate of small cell lung cancer was the highest ;Tumor markers of HE4 74 .42% 74 .42% ,47 .3% CYFRA21‐1 ,NSE ,illustrate the positive rate of single use these in‐dicators for testing are not high .Three joint detection sensitivity of 79 .72% ,specificity of 91 .08% .Conclusion Serum HE4 and CYFRA21‐1 ,NSE joint detection sensitivity and specificity is higher ,so suitable for early lung cancer as a diagnostic marker for joint detection .