血清肿瘤标志物联合检测对肺癌诊断的临床评价  

Clinical values of combination measurement of tumor markers in diagnosis of lung cancer

作　　者：张长军[1] 

机构地区：[1]北京市昌平区中医医院,北京102200

出　　处：《中国卫生检验杂志》2013年第1期158-161,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的:评价癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、鳞状细胞癌抗原(SCC)、糖链抗原125(CA125)和细胞角蛋白19片断(CYFRA21-1)对肺癌诊断的临床价值。方法:用化学发光免疫分析法测定103例肺癌、85例良性疾病和60健康对照血清CEA、NSE、SCC、CA125和CYFRA21-1水平。评价它们对肺癌的诊断价值。结果:肺癌患者血清CEA、NSE、SCC、CA125和CYFRA21-1水平显著高于良性疾病与健康对照(P<0.05)。腺癌患者血清CEA和CA125的水平及阳性率都显著高于鳞癌和小细胞癌(P<0.05),肺鳞癌患者血清CYFRA21-1和SCC的水平及阳性率显著高于腺癌和小细胞癌(P<0.05),小细胞肺癌患者血清NSE水平及阳性率显著高于腺癌和鳞癌(P<0.05)。五种肿瘤标志物单项检测的阳性率小于50%。在肿瘤标志物联合试验中,以CEA+NSE联合、CEA+NSE+CYFRA21-1联合、CEA+NSE+CYFRA21-1+CA125联合为最佳,它们对肺癌的阳性率分别为65.3%、70.9%和71.8%。结论:血清CEA、NSE、SCC、CYFRA21-1和CA125的水平和阳性率与肺癌的病理类型有关。肿瘤标志物联合检测可提高对肺癌的诊断灵敏度,首选CEA、NSE和CYFRA21-1三种肿瘤标志物联合。Objective：To evaluate the clinical values of carcinoembryonic antigen（CEA）,neuron specific enolase（NSE）,squamous cell carcinoma antigen（SCC）,carbohydrate antigen 125（CA125） and cytokeratin fragment 19（CYFRA21-1） for diagnosis of lung cancer.Methods： The levels of serum CEA,NSE,SCC,CA125 and CYFRA21-1 were measured in 103 lung cancer patients,85patients with benign lung diseases and 60 healthy persons.Results： The levels of CEA,NSE,SCC,CA125 and CYFRA21-1 were significantly higher in patients with lung cancer than those in patients with benign lung diseases and 60 healthy persons（P0.05）.The levels and positive rates of CEA and CA125 were significantly higher in patients with lung adenocarcinoma than those in patients with squamous cell carcinoma or small cell lung cancer.The levels and positive rates of SCC and CYFRA21-1 were significantly higher in patients with squamous cell carcinoma than those in patients with lung adenocarcinoma or small cell lung cancer.The level and positive rate of NSE were significantly higher in patients with small cell lung cancer than those in patients with squamous cell carcinoma or lung adenocarcinoma.The positive rate of single test of five tumor markers was less than 50%.The combination measurement of CEA＋NSE,CEA＋NSE＋CYFRA21-1,CEA＋NSE＋CA125＋CYFRA21-1 were better,their positive rates were 65.3%,70.9% and 71.8% in patients with lung cancer respectively.Conclusion： The levels and positive rates of serum CEA,NSE,SCC,CA125 and CYFRA21-1 were associated with pathology type of lung cancer.The combination measurement of serum CEA,NSE,SCC,CA125 and CYFRA21-1 increased the sensitivity for diagnosis of lung cancer,the combination measurement of CEA,NSE and CYFRA21-1 was the best choice.

关 键 词：肺癌 癌胚抗原 神经元特异性烯醇化酶 鳞状细胞癌抗原 糖链抗原125 细胞角蛋白19片断 

分 类 号：R734.2[医药卫生—肿瘤]