进展期肺癌肿瘤标记物临床应用价值

目的 :评价进展期肺癌患者血清癌胚抗原 (CEA)、神经元特异性烯醇化酶 (NSE)、细胞角蛋白19片段 (CYFRA2 1 1)水平在肺癌诊断、确定病理类型和病情评估方面的临床价值。方法 :采用生物素酶免法测定 79例ⅢA、ⅢB、Ⅳ期原发性肺癌和术后复发或转移患者血清CEA、NSE、CYFRA2 1 1水平。结果 :79例进展期肺癌患者治疗前CEA、NSE、CYFRA2 1 1明显高于正常对照组。 3项联合检测阳性率达 97 5 %。鳞癌组、腺癌组和小细胞未分化癌组之间肿瘤标记物水平差异有显著性。CEA水平以腺癌组最高 ,NSE水平以小细胞未分化癌组最高 ,CYFRA2 1 1水平以鳞癌组最高。化疗有效者肿瘤标记物水平降低 ,病情进展和肿瘤转移患者则升高。结论 :CEA、NSE、CYFRA2 1 1联合用于肺癌的诊断有极高的特异性和敏感性 ,NSE CYFRA2 1 1与肺癌的病理类型有很好的相关性 ,为无法做病理学检查的患者的治疗提供支持 ,此外在病情监测和疗效判断方面可为临床提供有价值的资料

Value of CEA,NSE and CYFRA21-1 in Patients with Advanced Lung Carcinoma

Objective To evaluate the value of CEA,NSE and CYFRA21 1 in patients with advanced lung carcinoma.Methods These tumor markers in serum were measured in 79 patients with advanced lung carcinoma using biotin strepavidin EIA.Results The level of CEA,NSE and CYFRA21 1 in patients with advanced lung carcinoma before treatment was significantly higher than that in controls.Single analysis showed that CEA for adenocarcinoma,NSE for small cell lung cancer and CYFRA21 1 for squamous carcinoma had higher positive rate.Combination of these tumor markers increased sensitivity.After chemotherapy (curative effects:CR PR),the serum levels of the markers in patients with object remission was decreased significantly.Conclusions Measurement of CEA,NSE and CYFRA21 1 in serum provides useful information for diagnosis and evaluation of disease extent in patients with advanced lung cancer.The ratio of NSE to CYFRA21 1 is a wonderful index correlated to the pathologic type.The changement of biomarkers serum level reflects the effects of chemotherapy. China J Cancer Prev Treat,2003,10(3):272-275