血清肿瘤标记物联合动态检测在肺癌诊断和监控治疗中的应用

目的探讨血清肿瘤标记物鳞状上皮细胞癌抗原（SCC-Ag）、癌胚抗原（CEA）、神经元特异性烯醇化酶（NSE）联合检测在肺癌诊断和监控治疗中的价值。方法采用电化学发光法检测116例肺癌患者（观察组）治疗（手术或放化疗）前和治疗后3个月血清SCC-Ag、CEA和NSE水平，并与50例肺部良性病变患者（对照组）作对照，分析血清肿瘤标记物SCC-Ag、CEA和NSE在肺癌诊断、临床分期、病理组织学分型和治疗监控中的价值。结果（1）肺癌组患者血清SCC-Ag、CEA和NSE水平明显高于肺部良性病变组（P＜0.01）；（2）肺癌组治疗后其血清肿瘤标记物水平较治疗前明显下降（P＜0.01）；（3）肺癌中晚期组、淋巴结转移组、复发组患者血清SCC-Ag、CEA和NSE水平较早期组、无转移组、无复发组明显增高（P＜0.01）；（4） SCC-Ag、CEA和NSE诊断肺癌的敏感性分别为60.34％、52.59％、49.14％；三项肿瘤标记物联合检测诊断肺癌的敏感性高达96.55％，与各单项检测诊断肺癌敏感性比较差异有统计学意义（P＜0.01）；（5） SCC-Ag对肺鳞癌阳性检出率与其他两种病理类型比较有统计学意义（P＜0.01）；CEA对肺腺癌阳性检出率与其他两种病理类型比较有统计学意义（P＜0.01）；NSE对肺小细胞癌阳性检出率与其他两种病理类型比较有统计学意义（P＜0.01）。结论血清肿瘤标记物SCC-Ag、CEA和NSE水平与肺癌的临床分期、病理组织学类型及预后相关，联合动态检测可作为肺癌早期诊断的辅助手段和治疗有效性及疾病复发的监控指标，有利于临床早期发现、早期治疗。

The application of combined detection of serum tumor markers in diagnosis and monitoring treatment of lung cancer

Objective To investigate the value of combined detection of serum tumor markers of SCC -Ag, CEA and NSE in diagnosis and monitoring treatment of lung cancer .Methods The serum tumor markers of SCC-Ag,CEA and NSE of 116 cases of lung cancer patients （ observation group ） were detected by the electrochemical luminescence method ,when they were preoperative and postoperative .The data were compared with that of 50 cases of benign lung tumor patients （ control group ） ,and the value of serum tumor markers of SCC-Ag,CEA and NSE used in early diagnosis of lung cancer , distinguishing pathological types , clinical staging and monitoring treatment was analyzed.Results （1） The levels of the tumor markers of SCC-Ag,CEA and NSE of lung cancer group were apparently higher than those of benign lung tumor group （ P〈0.01 ） .（ 2 ） The levels of the tumor markers of lung cancer group which were postoperative dramatic declined comparing with those preoperative .（ 3 ） The levels of the tumor markers of SCC-Ag,CEA and NSE of middle-advanced stages caner patients ,metastasis of lymph nodes of lung cancer patients and recurrent patients were significantly higher comparing with those of early stage , negative for metastatic tumor and with no recurrence .（4）The diagnosis of lung cancer sensitivity of SCC-Ag,CEA and NSE were 60.34%,52.59%and 49.14%.The sensitivity of combined detection can reach up to 96.55%,which was statistical significant comparing with each individual indicator （ P〈0.01 ） .（ 5 ） The expression of squamous cell carcinoma of SCC-Ag was statistical significant comparing with the other pathological types （ P〈0.01 ） .The expression of lung adenocarcinoma of CEA was statistical significant （P〈0.01）,and that of small cell carcinoma of NSE was statistical significant（P 〈0.01 ）.Conclusion The levels of SCC-Ag, CEA and NSE were related with clinical staging ,＆amp;nbsp;distinguishing pathological types and prognosis .The combined dynamic detection of SCC-Ag,CEA and NSE is a good indicator of early diagnosis , monitoring treatment and recrudescence of lung cancer , which is favorable for clinical early detection and early intervention .