肺癌患者血清CEA、CYFRA21-1和NSE的检测及临床意义

目的探讨外周血癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)和神经元特异性烯醇化酶(NSE)的检测对肺癌的诊断、病理分型和疗效判断的临床用价值。方法采用化学发光法检测了62例肺癌患者、54例良性肺部疾病患者、36例健康人、40例肺癌患者手术前后血清CEA、CYFRA21-1和NSE的水平。结果肺癌患者手术前血清CEA、CYFRA21-1和NSE的含量明显高于良性肺部疾病组及正常对照组(P0.01)。鳞癌组、腺癌组和小细胞癌组之间肿瘤标志物CEA、CYFRA21-1和NSE水平差异有统计学意义。CEA阳性率以腺癌组最高(84%),CYFRA21-1阳性率以鳞癌组最高(85.2%),NSE阳性率以小细胞癌组最高(80.0%)。手术治疗后未复发转移组CEA、CYFRA21-1和NSE水平低于术前,而复发转移组与术前比变化不显著(P0.05)。结论血清CEA、CYFRA21-1和NSE的检测对不同病理类型肺癌患者的诊断、病情检测及疗效判断有较好的临床参考价值。

Detection and clinical significance of serum CEA,CYFRA21-1 and NSE in patients with lung cancer

Objective To investigate the value of detection of serum CEA,CYFRA21-1 and NSE to the diagnosis,pathological classification and therapeutic efficiency of lung carcinoma.Method Serum CEA,CYFRA21-1 and NSE were measured with chemilum inescence immunoassay in 62 cases of lung cancer,54 cases of benign pulmonary disease,36 cases of healthy controls and 40 cases of lung cancer before and after surgery.Result The levels of CEA,CYFRA21-1 and NSE in patients with lung carcinoma before surgery were higher than those in patients with benign pulmonary diseases and healthy controls（P 0.01）.Single analysis showed that the highest positive rates of CEA,CYFRA21-1 and NSE were seen in adenocarcinoma,squamous carcinoma and small cell lung cancer,respectively;the serum levels were decreased than those before surgery in the non-recurrence group,but increased or remained unchanged in the recurrence group.Conclusion Measurement of CEA,CYFRA21-1 and NSE in serum provides useful information for diagnosis,monitoring and effects assessment of the chemotherapy of lung cancer with different pathological types.