血清CYFRA21－1免疫放射分析在非小细胞肺癌诊断中的临床价值  

Analysis of Serum CYFR21-1 by Immunoradiometric Assay in Patients with Non-small Cell Lung Cancerc

作　　者：郭华北[1] 蒋秉坤[1] 

机构地区：[1]安徽蚌埠医学院临床生化教研室

出　　处：《中国肿瘤临床》1996年第4期236-239,共4页Chinese Journal of Clinical Oncology

摘　　要：ＣＹＦＲＡ２１－１是细胞角蛋白１９的片段（ＣＫ１９）。免疫放射法（ＩＲＭＡ）测定１３３例肺癌患者血清中ＣＹＦＲＡ２１－１水平，与血清神经元特异性烯醇化酶（ＮＳＥ）作比较，初步观察了５例非小细胞肺癌患者血清ＣＹＦＲＡ２１－１在治疗过程中的动态变化。结果表明肺癌患者血清ＣＹＦＲＡ２１－１水平明显高于肺良性疾患组（Ｐ＜０．００１）和正常对照组（Ｐ＜０．００１）；在肺癌患者，血清ＣＹＦＲＡ２１－１水平升高主要出现在非小细胞肺癌组，尤其是鳞癌组，阳性诊断率分别为５２．８％和７２．１％，明显高于小细胞肺癌组（２７．３％）（Ｐ＜０．０１，Ｐ＜０．００１），在非小细胞肺癌组，血清ＣＹＦＲＡ２１－１与肿瘤临床分期相关。其阳性诊断率１期为３５．３％，Ⅰ期为５５．６％，Ⅱ期为６３．６％，Ⅳ期为７３．３％；血清ＮＳＥ水平的升高以小细胞肺癌为主，阳性率为５９．１％，高于非小细胞肺癌组（２１．３％，Ｐ＜０．００１），鳞癌组（２７．９％，Ｐ＜０．００１）。联合检测血清ＣＹＦＲＡ２１－１和ＮＳＥ可将整体肺癌的阳性诊断率提高至６１．７％。对血清ＣＹＦＲＡ２１－１的动态监测显示肿瘤进展时其水平持续升高。病人预后较差，水平的下降提示疾病缓解。检?The fragements of serum cytokeratin 19 subunit, referred to as CYFRA21-1 were determined using immunoradiometric assay in 133 patients with lung cancer.CYFRA21-1 was significantly higher in lung cancer patients than that of benign pulmonary disease and healthy adults(P<0.001 ).Compared to serum NSE, CYFRA21-1 was more frequently elevated in patients with non-small cell cancer(NSCLC)(Sensitivity:52.8% ),especially squamous cell carcinoma(SQC)(72.1%),than in that with small cell lung cancer(SCLC)(27.3%,P<0.01,P<0.001).In NSCLC, elevated CYFRA21-1 was measured in 35.3% for stageⅠ,55.6%for stageⅡ,63.6% for stage Ⅲ and 73.3% for stage Ⅲ diseases.Elevated NSE was dominant in SCLC with a sensitivity of 59.1%.The sensitivty of all lung cancer case was soared to 61.7% or even higher by combining CYFRA21-1 and NSE.The decline of CYFRA21-1was observed when remission of the tumor became clinically evident.CYFRA21-1seemed to be of clinical interest for NSCLC,particularly so for SQC.

关 键 词：肺肿瘤 NSCLC 鳞癌 免疫放射分析 CYFRA21-1 

分 类 号：R734.204[医药卫生—肿瘤]