血清NSE、CYFRA21-1、CEA联合检测对肺癌临床诊断的价值

[目的]探讨血清神经元特异性烯醇化酶(NSE)、细胞角蛋白19片(CYFRA21-1)、癌胚抗原(CEA)水平在各种病理类型肺癌诊断中的价值.[方法]测定68例肺癌(腺癌24例、鳞癌34例、小细胞癌10例)患者NSE、CYFRA21-1、CEA水平,并与16例肺结核、22例肺部感染患者比较.[结果] NSE、CYFRA21-1、CEA分别在小细胞肺癌组(SCLC)、鳞癌组、腺癌组中最高,NSE和CEA与其他组均有显著性差异(P＜0.01);CYFRA21-1在腺癌组其次,鳞癌组与腺癌组之间有差异((P＜0.05),与其他组相比有显著差异(P＜0.01),但腺癌组与其他组无差异(P＞0.05);单项检测中CYFRA21-1、CEA的敏感度及准确度均高于NSE(P＜0.01).三项联合检测敏感度最高,而两两联合、CYFRA21-1与CEA之间均无差异.三项联合和CYFRA21-1 CEA两两联合的准确度高于其他,NSE CYFRA21-1、NSE CEA两两联合、CYFRA21-1和CEA之间均无差异.不论单项还是联合检测特异度均无差异(P＜0.05).[结论]血清NSE、CYFRA21-1、CEA对肺癌诊断有较高的临床参考价值,并有助于肺癌的病理类型评估.三项联合检测可提高检测肺癌的敏感度和准确度,并不降低特异度,特别为临床无法做病理学检查的患者的诊断提供依据.

Diagnostic Value of Combined Detection of Serum NSE, CYFRA21-1 and CEA in Lung Cancer

To explore the value of combined detection of serum NSE, CYFRA21-1 and CEA for the diagnosis of lung cancer. Levels of serum NSE, CYFRA21-1, CEA were measured in 24 cases with lung adenocarcinoma, 34 cases with lung squamous cell carcinoma, 10 cases with small cell lung cancer (SCLC), 16 patients with pulmonary tuberculosis(TB) and 22 patients with respiratory infection. The highest serum NSE, CYFRA21-1, CEA were detected in SCLC, lung squamous cell carcinoma respectively and adenocarcinoma and there were significantly different with the other patterns of lung cancer, TB and respiratory infection. The sensitivity of the combined detection of NSE, CYFRA21-1, CEA was higher than that of detecting 1 or 2 of the above 3 markers. There was no difference among 2 of the above 3 single CYFRA21-1, and CEA. The accuracy of the combined detection of the above 3 as well as CYFRA21-1 and CEA were better than others. The sensitivity and accuracy of detection of NSE, CYFRA21-1 were higher than those of NSE. The specificity of detecting 1 or 2 or 3 of the above 3 markers was not significantly different. [Conclusion] This results suggest that the measurement of serum NSE, CYFRA21-1 and CEA is a useful diagnostic tool and helpful to evaluate the pathological type of lung carcinoma. Combination of them can improve the diagnostic sensitivity, specitity especially in providing diagnostic evidence for those without pathology proved.