TPS、CEA和CYFRA21-Ⅰ联合检测在肺癌中的临床价值

目的探讨肺癌患者血清中组织多肽特异性抗原（TPS）、癌胚抗原（CEA）和细胞角蛋白19片段（CYFRA21-1）的临床应用价值。方法应用ELISA法分别检测60例肺癌患者，54例良性肺部疾病和40名健康成人血清中TPS、CYFRA21-1和CEA水平，并对28例肺癌患者进行术后1个月和3个月的随访检测。结果肺癌组血清中TPS、CEA和CYFRA21-1水平明显高于良性肺疾病组和健康对照组（P〈0．05）。3种肿瘤标志物单项检测时，以TPS的敏感性（78．3％）和准确性（82．5％）最高；多项指标联合检测时，以TPS＋CEA＋CYFRA21-1组合获得的敏感性（95．0％）和准确性（85．1％）最高，但特异性有所降低。3种肿瘤标志物水平随临床分期（TNM）增加而升高，Ⅰ、Ⅱ期和Ⅲ期比较，TPS和CEA差异有统计学意义（P〈0．05），Ⅰ、Ⅱ期和Ⅳ期比较，TPS、CEA和CYFRA21-1差异均有统计学意义（P〈0．05）。手术治疗后，3种肿瘤标志物均较术前明显下降。结论3种肿瘤标志物在肺癌的诊断治疗中，具有一定的临床应用价值。TPS＋CEA＋CYFRA21-1组合可明显提高肺癌诊断的敏感性和准确性。

The clinical value of combined determination of three tumor markers in lung cancer

Objective To investigate the clinical value of combined determination of tissue polypeptide specific antigen （TPS）, cytokeratin- 19-fragments （ CYFRA21-1 ）and carcinoembryonic antigen （ CEA）in lung cancer patients. Methods The concentration of three tumor markers in serum was detected by ELISA in 60 lung cancer patients, 54 benign lung disease patients and 40 healthy people. Moreover follow-up visit was undertaken at one month and three months after surgery for lung cancer patients. Results The level of TPS, CEA and CYFRA21-1 was lsignificantly higher in lung cancer than that in benign lung disease and health controls （P〈0.05）. TPS showed the highest sensitivity （78.3%）and accuracy （82.5%）in single tumor marker detection, and TPS＋CEA＋CYFRA21-1 showed the highest sensitivity （95.0%）and accuracy （ 85.1% ）in combined tumor marker detection for diagnosis of lung cancer in serum. The value of TPS, CEA and CYFRA21-1 changed in relationship to stage of disease. There were statistically sigrtificant in the serum level of TPS and CEA between stage Ⅰ、Ⅱ and stage Ⅲ（P〈0.05）. We also found the level of TPS, CEA and CYFRA21-1 in stage Ⅳ was evidently higher than that in stage Ⅰ、Ⅱ . After operation, a marked decrease in these values were observed. It may be used for assessing curative effect after-operation. Conclusion There was specifically clinical application value of these three tumor markers for diagnosis and cure of lung cancer. The sensitivity and accuracy can be increase with combination of TPS＋CEA＋CYFRA21-1 in diagnosis of lung cancer.