CA199、NSE、CYFRA21-1、TPS和CEA联合检测在肺癌诊断中的应用价值

目的 探讨肿瘤标记物CA199、NSE、CYFRA21-1、TPS和CEA在肺癌诊断中的应用价值.方法 选择67例肺癌患者、42例肺良性病变患者和30例健康体检者为研究对象,分别测定3组研究对象的血清肿瘤标记物水平.结果 肺癌组血清肿瘤标志物CA199、NSE、CYFRA21-1、TPS和CEA水平均明显高于肺良性病变组和健康对照组,差异有显著性（P＜0.05）.CA199、NSE、CYFRA21-1、TPS和CEA诊断肺癌的敏感度分别为23.88％、41.79％、32.84％、82.09％和50.75％,特异性分别为94.44％、70.83％、100.00％、69.44％和100.00％.小细胞癌患者NSE水平明显高于腺癌和鳞癌（P＜0.05）,其他肿瘤标志物水平不同病理组比较差异无统计学意义（P＞0.05）.联合检测时,随着检测项目的增加,敏感度增加,但特异性下降,各项组合中以含TPS的敏感度较好.5项肿瘤标志物联合检测敏感度提高到98.51％,但特异性下降到54.17％.结论 联合检测CA199、NSE、CYFRA21-1、TPS和CEA可以显著提高肺癌诊断的敏感度,值得临床推广.

The diagnostic value of CA199, NSE,CYFRA21-1, TPS and CEA cinjoined detection for lung cancer

Objective To study diagnostic value of carbohydrate antigen 199 （CA199）,Neuron-specific enolase （NSE）,Cytokeratin fragment 19（CYFRA21-1）,Tissue polypeptide specific antigen （TPS） and Carcinoembryonic antigen （CEA） cinjoined detection for lung cancer.Methods 67 cases with lung cancer,42 cases with benign lung diseases and 30 health persons were choosed.The levels of serum tumor markers of the three groups were determined.Results Levels of CA199,NSE,CYFRA21-1,TPS and CEA of lunger cancert group were significantly higher than them of benign lung disease group or healthy control group（P〈0.05）.The sensitivity of CA199,NSE,CYFRA21-1,TPS and CEA respectively were 23.88%,41.79%,32.84%,82.09% and 50.75%,and the specificity respectively were 94.44%,70.83%,100.00%,69.44% and 100.00%.NSE level of small cell cancer group was obviously higher than that of adenocarcinoma group or squamous cell carcinomas group（P〈0.05）.And other tumor markers＇ levels had no statistically significant difference compared different pathological groups（P〈0.05）.With the increase of the test items,sensitivity increased,but specificity went down,and in which the combinations included TPS was more sensitive.The combinations＇ sensitivity was 98.51%,but the specificity had no obvious fell to 54.17%.Conclusion CA199,NSE,CYFRA21-1,TPS and CEA cinjoined detection for lung cancer has high sensitivity,is worthy of clinical promotion.