CYFRA21-1在肺癌诊断与监测中的应用研究  

Clinical Utility of CYFRA21－1 as a diagnositic and monitoring marker in lung cancer

作　　者：邹学森[1] 匡裕康[1] 吕霞[1] 熊建萍[1] 黎虹[1] 

机构地区：[1]江西省肿瘤医院,南昌330029

出　　处：《江西医药》2001年第2期99-101,共3页Jiangxi Medical Journal

基　　金：江西省卫生厅资助项目

摘　　要：目的 探讨CYFRA21－1对肺癌的诊断、疗效监测和预后判断价值。方法 采用酶免疫分析（EIA）方法对111例经病理确诊的肺癌和62例非癌对照组血清CYFRA21－1进行测定，阈值为3．3μg／L。结果 肺癌组CYFRA21－1浓度为6．1μg／L，显著高于对照组的1．6μg／L（P＜0．001），肺癌组和对照组CYERA21－1阳性率分别为80．2％和6．5％，诊断特异性93．5％。NSCLC组CYERA21－1阳性率86．4％，显著高于SCLC组（P＜O．01）。血清CYFRA21－1浓度随肺癌分期升高而增加（P＜0．05）。对37例接受手术和12例接受化疗的病人血清CYERA21－1变化分析显示，手术病人血清值由术前的6．2μg／L降到术后2．2μg／L（P＜0．001）；6例化PR者由治疗前的5．0μg／L降至2．4μg／L。6例化疗无效进展者，血清值也相应增加。13例肺癌病人CYFRA21－1动态观察显示，肿瘤情况的变化也常伴随着CYFRA21－1的相应变化。 结论 血清CYFRA21－1水平在肺癌中显著增加，并随病情变化而改变。CYFRA21－1测定有助于肺癌诊断、疗效监测和病情变化的判断。Objective To evaluate the Significance of CYFRA21－1（the soluble fragment of Cytokeratin 19） as a marker for diagnosis and assessment of therapeutic effect and disease Change in lung cancer． Methods The Serum levels of CYFRA21－1 in 111 case of lung cancer patients and in 62 noncarcinoma individuals were measured by enzym－linked immunoassay． The cut－off value was 3．3μg／L according to the manufacturer． Results The concentration of CYFRA21－1 in lung cancer group was 6．1μg／L（median）， and significantly higher than 1．6μg／L（median） in noncarinoma Control group（P＜0．001）． The positive rates of CYFRA21－1 in lung cancer and in control were 80．2％ and 6．5％， respectively． The diagnostic Specificity for lung cancer was 93．5％． The positive rate of CYFRA21－1 in NSCLC was 86．4％， higher than 53．3％ in SCLC（P＜0．01）． The deferences in concentration and positive rate between squamous cell carcinoma and adenocarcinoma were not significant（P＞0．5）． CYFRA21－1 concentration in lung cancer patients increased with stage increasing（P＜0．05）． Analysis on changes of CYFRA21－1 levels among 37 patients receiving operaiton and 12 patients receiving chemotherapy showed that CYFRA21－1 level decreased from 6．2μg／L before operation to 2．2μg／L after operation， and that in 6 patients， who got PR chemotherapeutic effect， decreased from 5．0μg／L to 2．4μg／L， but increased in other 6 patients whose disease progressed． Conclusion The serum CYFRA21－1 level increased significantly and altered with the change of the disease in lung cancer． The determination of serum CYFRA21－1 have important value in diagnosis， evaluation of therapeutic effect and the disease change of Lung cancer．

关 键 词：肺癌 诊断 CYFRA21-1 角质蛋白19 

分 类 号：R734.2[医药卫生—肿瘤]