肺癌患者血清肿瘤标志物检测的临床意义

目的测定小细胞肺癌和晚期非小细胞肺癌患者化疗前后癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)、神经元特异性烯醇化酶(NSE)的变化,并探讨该种变化的临床意义.方法用放射免疫分析的方法分别测定20例肺部良性疾病、20例广泛期小细胞肺癌(SCLC)以及45例初诊晚期非小细胞肺癌(NSCLC)患者化疗前后血清CEA、CYFRA21-1、NSE的水平,再分别作对比分析.结果肺癌组CEA、CYFRA21-1、NSE的水平高于良性疾病组,但CYFRA21-1在良性疾病和小细胞肺癌中、NSE在良性疾病和鳞癌以及良性疾病和腺癌中均未见统计学差异(P>0.05);化疗后小细胞肺癌患者NSE显著下降(P<0.01),鳞癌患者CYFRA21-1 水平显著下降(P<0.01),但在腺癌患者只有NSE水平较化疗前下降,另两种标志物未见统计学差异(P>0.05).结论三种肿瘤标志物在非小细胞肺癌晚期均升高,其中CEA在腺癌、CYFRA21-1在鳞癌、NSE在SCLC中尤为明显,化疗后显著下降,三种指标的测定有助于肺癌的病理分型,并且可以分别作为判定不同病理类型肺癌化疗疗效的指标.

Clinical Significance of Serum Tumor Markers in Patients with Lung Cancer

Objective To detect values of carcinoembryonic antigen (CEA),cytokeratin fragment antigen21-1 (CYFRA21-1) and neuron specific enolase (NSE) in patients with advanced non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). To measure the changes of the three tumor markers after chemotherapy, and to study the clinical significance of the changes.Methods Radioimmunoassay was available to detect the levels of CEA, CYFRA21-1, NSE in 45 patients with advanced NSCLC before and after chemotherapy. The three tumor markers were also detected in 20 patients with SCLC and 20 patients with benign lung diseases as control groups. Results The levels of CEA, CYFRA21-1, NSE in lung cancer group before chemotherapy were higher than benign group, but there was no difference of CYFRA21-1 between the SCLC group and benign group, nor difference of NSE between NSCLC and benign group (P>0.05). The value of NSE was lower in the patients with SCLC after chemotherapy than before (P<0.01). The level of CYFRA21-1 was lower in squamous carcinoma than before (P<0.01). But in the adenocarcinoma group only NSE's level was lower after chemotherapy (P<0.05), there were no significant changes in CEA and CYFRA21-1 (P>0.05). Conclusion In our study, the levels of the three tumor markers rose in advanced NSCLC and decreased after chemotherapy. The changes were significant with NSE in SCLC and CYFRA21-1 in squamous cell carcinoma and CEA in adenocarcinoma.CEA, CYFRA21-1 and NSE might be tumor markers in progressive lung cancer. And the decrease of these tumor markers' levels could be used to evaluate the chemotherapeutic response respectively in different pathologic types of lung cancer.