血清CEA、NSE、CYFRA21-1在肺癌诊断、治疗监测及判断预后中的价值  

Value of serum CEA,NSE and CYFRA21-1 in diagnosis,therapeutic efficiency and prognostic estimation in lung carcinoma

作　　者：许方[1] 王卫东[1] 胡宏[1] 衣明[2] 

机构地区：[1]大连医科大学附属第二医院检验科,辽宁大连116027 [2]大连医科大学检验医学院,辽宁大连116044

出　　处：《大连医科大学学报》2008年第4期381-384,397,共5页Journal of Dalian Medical University

摘　　要：[目的]探讨外周血中CEA、NSE、CYFRA21-1在肺癌的诊断、病理分型、临床分期、病程监测、疗效观察及预后评估方面的意义。[方法]采用电化学发光技术,检测65例肺癌患者手术治疗和/或化学治疗前后,30例肺部良性疾病患者及30例健康体检者血清中CEA、NSE、CYFRA21-1水平。[结果]肺癌组治疗前CEA、NSE、CYFRA21-1水平分别为(96.31±100.51)ng/mL、(36.24±34.42)ng/mL、(8.04±7.12)ng/mL,与正常对照组及肺部良性疾病组相比差异有显著性意义(P均<0.01);不同病理类型肺癌组中三种肿瘤标记物(TM)的水平比较差异有显著性意义(P<0.01);CEA、NSE、CYFRA21-1的水平与临床分期有一定的关系;三项指标联合检测与各个单项指标检测比较,对肺癌诊断的敏感性明显增高(P<0.05),特异性虽有降低但差异无显著性意义(P>0.05);肺癌组手术或化疗有效者三项水平明显下降,病情稳定和进展者三者水平无变化或升高。[结论]血清CEA、NSE、CY-FRA21-1联合检测在肺癌的诊断方面有较好的临床参考价值,并有助于肺癌病理分型,亦可作为肺癌病情监测疗效判断和评价预后等方面有价值的指标。[Objective] To investigate the value of serum CEA,NSE and CYFRA21-1in the diagnosis,pathological classification,stage and therapeutic efficiency in lung carcinoma.[Methods] Using electrochemiluminescence immunoassay,the serum CEA,NSE and CYFRA21-1 levels were measured in 55 cases of lung cancer before and after chemotherapy,as well as in 30 cases of benign pulmonary diseases and 30 cases of healthy controls.[Results] The levels of CEA,NSE and CYFRA21-1 in Patients with lung carcinoma before chemotherapy were significantly higher than those in benign pulmonary diseases and normal controls（P〈0.01）.Different types of lung cancer pathology group of three tumor markers（TM） level of significant difference（P〈0.01）,CEA,NSE,CYFRA21-1 level with clinical staging of increment and increase there were significant differences（P〈0.01）.Combined detection of these tumor markers has an increased sensitivity（P〈0.05）.After chemotherapy,the serum levels of the markers were decreased significantly in the CR and PR patients.but increased or not changed in patients with advanced disease or metastases.[Conclusions] Combined detection of serum CEA,NSE and CYFRA21-1 has a high sensitivity in the diagnosis of lung cancer.The three markers correlate closely with the pathological type and have a value in the treatment of patients who is unable to receive pathological examination.CEA,NSE and CYFRA21-1 can be used as valuable markers for monitoring and evaluation of therapeutic efficacy in lung cancer.

关 键 词：肺癌 癌胚抗原 细胞角蛋白21-1 神经元特异性烯醇化酶 

分 类 号：R734.2[医药卫生—肿瘤]