血清Cyfra21-1、CEA、NSE监测肺癌骨转移的临床意义

目的:通过对肺癌患者肿瘤标志物骨胶素-细胞角蛋白19片段(Cyfra21-1)、癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)水平的测定,探讨肺癌骨转移患者血清Cyfra21-1、CEA、NSE水平变化,并评价其监测肺癌骨转移的临床意义。方法:对101例经病理或穿刺活检证实为肺癌的患者行99m锝-亚甲基二磷酸盐(99mTc-MDP)全身骨显像,根据骨转移诊断标准将肺癌患者分为未转移组(52例)、单发骨转移组(19例)、多发骨转移组(30例),同时对101例肺癌患者及30例肺部良性疾病患者进行血清Cyfra21-1、CEA、NSE水平测定,比较各组间血清Cyfra21-1、CEA、NSE水平的变化,并通过受试者工作特征曲线(Receiver operator characteristic curve,ROC曲线)评价其监测肺癌骨转移的准确性。结果:肺癌组血清Cyfra21-1、CEA、NSE水平明显高于肺部良性病变组(P0.01);肺癌骨转移组血清Cyfra21-1、CEA、NSE水平明显高于未转移组(P0.01),其中多发骨转移组明显高于单发骨转移组(P0.05);血清Cyfra21-1、CEA、NSE的曲线下面积(Area under the ROC curves,AUC)分别为0.767、0.850、0.813,血清Cyfra21-1和CEA的敏感度最高,均为91.80%,血清NSE的特异度最高,为73.10%。结论:血清Cyfra21-1、CEA、NSE可作为肺癌骨转移的初筛及监测方法。

The change of serum Cyfra21 -1,CEA,NSE levels in bone metastases of lung cancer and its evaluation of accuracy

Objective To explore the change of serum Cyfra21 -1、CEA、NSE levels in different degrees of bone metastases of lung cancer and evaluation of accuracy in diagnosing bone metastasis by mensuring the level of soluble fragment Cyfra21 -1 of cytokera-tin 19 （CK19）,carcinoembryonic antigen （CEA）and neuronspecific enolase （NSE）. Methods 101 lung cancer patients con-firmed by pathology or needle biopsy were underwent whole body bone images,and divided into without bone metastases （52 per-sons）,single-bone metastases （19 persons）and multiplt-bone metastases （30 persons）groups according to the different degrees of bone metastasis. We detected the levels of serum Cyfra21 -1、CEA、NSE of 101 patients and 30 lung benign disease patients and compared the change of tumor makers＆#39;level in each group,evaluation of accuracy in diagnosing bone metastasis by receiver operating characteristic curve. Results The level of serum Cyfra21 -1、CEA、NSE in lung cancer group were much higher than lung benign dis-ease （P＆lt;0.01）,the level of serum Cyfra21 -1、CEA、NSE in lung cancer with bone metastasis group were much higher than with-out bone metastasis （P＆lt;0.01）,and multiplt-bone metastases were much higher than single-bone metastases （P＆lt;0.05）,The ar-ea under the curve of surem Cyfra21 -1、CEA 、NSE were 0.767,0.850,0.813,The serum Cyfra21 -1 and CEA had the highest sensitivity that is 91.8%,the serum NSE of the highest specificity,73.10%.Conclusion Serum Cyfra21 -1,CEA,NSE has a higher accuracy in diagnosing bone metastasis of lung cancer,and can be used as a method in screening and monitoring bone metastasis.