联合检测血清中CYFRA21-1、NSE对肺癌诊断的价值

目的探讨联合检测血清中肿瘤标记物CYFRA21-1、NSE对肺癌早期诊断、病情监测及疗效判定的价值。方法将肺癌患者分为非小细胞肺癌组(NSCLC)和小细胞肺癌组(SCLC),以健康人及肺部良性病变患者(BLD)为对照组。静脉取血,采用免疫放射法(IRMA)、放射免疫法(RIA)分别检测血清CYFRA21-1和NSE。结果血清CYFRA21-1水平在NSCLC组明显高于SCLC和BLD组(P<0.01),其对NSCLC诊断的阳性率显著高于SCLC组(58.1%vs16.7%,P<0.01)。NSE则在SCLC组明显高于NSCLC和BLD组(P<0.01),其对SCLC诊断的阳性率为66.7%,显著高于NSCLC组24.3%(P<0.01)。血清CYFRA21-1、NSE联合检测与各单项指标相比,可将肺癌诊断的敏感度、特异度和阳性率分别提高到79.1%、91.7%和85.0%(P<0.01)。此外,在NSCLC组,血清CYFRA21-1含量变化与肿瘤分期呈正相关,且与患者病情的变化有相关性。结论联合检测血清中CYFRA21-1、NSE水平可明显提高肺癌早期诊断的阳性率,从而提高肺癌的早期诊断。临床上动态监测血清CYFRA21-1水平对NSCLC的进程及疗效判断有一定的价值。

Value of combination detection of serum CYFRA21-1 and NSE in the diagnosis of lung cancer

Objective To evaluate the combined determinations of tumor marker CYFRA21-1 and NSE in the early diagnosis,therapeutic monitoring and prognosis of lung cancer.Methods The lung cancer patients were randomly divided into the non-small-cell lung cancer(NSCLC)and small-cell lung cancer(SCLC).The healthy and benign lung disease(BLD)were used as control group.The levels of serum CYFRA21-1 and NSE were measured by IRMA and RIA methods.Results The level of serum CYFRA21-1 was higher in NSCLC group than that in SCLC and BLD group.But the level of serum NSE was higher in SCLC group than that in NSCLC and BLD group.The level of serum CYFRA21-1 was highest in NSCLC group,and the positive rate was 58.1%,which was higher than16.7% in SCLC group(P<0.01).In NSCLC group,the change of serum CYFRA21-1 content was positively correlated with the stage of tumors variety as well as disease condition.The SCLC group dominated in the improvement of serum NSE and the positive rate was 66.7% which was higher than 24.3% in NSCLC group(P<0.01).By logistic regression analysis,compared to each single index,the sensitivity,specificity and accuracy rates of the combination measurement of serum CYFRA21-1 and NSE were 79.1%,97.1% and 85.0% respectively.Conclusion Combination detection of CYFRA21-1 and NSE can be a useful addition in the early diagnosis of peripheral type carcinoma of lung.