中晚期肺癌伴肺真菌感染临床分析及肿瘤标志物表达水平观察

目的探讨肺癌及并发肺部真菌感染的发病原因、诊断和治疗。方法 110例肺癌患者（肺癌组）中20例患者合并肺部真菌感染,随机抽取45例同期健康体检者为对照组。对肺癌伴肺真菌感染患者的症状、痰培养、影像学诊断、抗生素、激素等使用情况进行分析。检测所有患者血清肿瘤标志物CEA、CA125、CYFRA21-1、NSE水平。结果 20例肺部真菌感染患者中,曾经化疗者18例,反复使用过广谱抗生素治疗者18例,使用过激素者12例。肺癌组血清CEA、CA125、CYFRA21-1、NSE水平均明显高于对照组（P〈0.01）;4项肿瘤标志物联合检测灵敏度及准确性均高于单一检测。结论肺癌合并肺部真菌感染原因与化疗、体质差、大量广谱抗生素的反复应用、激素应用等有关,应及早行病原学检查,足量强效抗真菌治疗,并达到病原学完全缓解。CEA、CA125、CYFRA21-1、NSE对肺癌血清学诊断具有重要意义。

Clinical analysis of moderate-advanced lung cancer complicated with pulmonary fungal infection and observation of expression levels of tumor markers

Objective To explore causes,diagnosis and treatment of lung cancer complicated with pulmonary fungal infection.Methods Twenty out of 110 patients with lung cancer（lung cancer group） were complicated with pulmonary fungal infection.Another 45 healthy subjects at the same period were randomly selected as the control group.The symptoms of lung cancer patients complicated with pulmonary fungal infection,sputum culture,radiographic diagnosis,the usage of antibiotics and hormones were analyzed.Serum tumor markers such as CEA,CA125,CYFRA21-1 and NSE level were detected in all the patients.Results Among those 20 patients,18 underwent chemotherapy, 18 had repeated intake of broad-spectrum antibiotics,and 12 used hormones.The serum CEA,CA125,CYFRA21-1 and NSE levels were significantly higher in the cancer group（P 0.01） than in the control group.The combined detection of the 4 tumor marker were of higher sensitivity and accuracy than the single detection.Conclusion Occurrence of lung cancer complicated by pulmonary fungal infection is related to chemotherapy,weak physical constitution,repeated intake of broad-spectrum antibiotics and hormones.The patients should be examined earlier with etiology and given adequate anti-fungal treatment to achieve complete remission from an etiologic perspective.CEA,CA125,CYFRA21-1 and NSE are of great importance to the serological diagnosis of lung cancer.