血清CEA,ProGRP,NSE和CYFRA21-1联合检测在肺癌诊断中的应用研究  

Clinical Application of Combined Detection of CEA,ProGRP,NSE and CYFRA21-1 in Diagnosis of Lung Cancer

作　　者：张萍[1] 王红义[2] 杨迎桂[1] 赵晋[1] 彭俊华[1] 

机构地区：[1]兰州军区兰州总医院检验科动物实验科,兰州730050 [2]兰州军区兰州总医院动物实验科,兰州730050

出　　处：《现代检验医学杂志》2016年第2期56-59,共4页Journal of Modern Laboratory Medicine

摘　　要：目的研究血清癌胚抗原（CEA）、胃泌素释放前体（ProGRP）、神经元特异性烯醇化酶（NSE）和细胞角蛋白19片段（CYFRA21—1）联合检测在肺癌诊断中的应用。方法空腹取诊断明确的133例肺癌患者、67例肺部良性病变患者及同期66例体检健康者（对照组）的静脉血，用化学发光法检测血清CYFRA21-1，CEA，NSE和ProGRP水平，并计算敏感度、准确度和特异度。结果CYFRA21—1，CEA，NSE和ProGR水平，肺癌患者血清分别为6．31±1．04ng／ml，20．58±2．41ng／ml，32．74±3．24ng／ml和125．78±15．32pg／ml，肺良性病变患者血清分别为1．93±0．52ng／m1，2．93±0．82ng／ml，10．49±1．93ng／ml和48．32±6．72pg／ml，对照组血清分别为1．56±0．45ng／ml，2．67±0．74ng／ml，8．34±1．2ng／ml和35．78±4．2pg／ml，肺癌患者血清CEA，ProGRP，NSE，CYFRA21—1水平均高于肺良性病变患者（t=1．48～2．78，P=0．13～0．25）和对照组（t=1．981～2．371，P=0．21～0．41），差异均有统计学意义（P〈0．05）。CYFRA21—1，NSE，CEA和Pro—GRP单项检测肺癌的敏感度分别为61．65％，45．86％，52．63％和63．91％，准确度为72．36％，63．81％，67．34％和74．87％。联合两项、三项检测肺癌，敏感度为72％～89％，准确度为78．89％～89．44％。四项联合检测肺癌的敏感度（92．48％）、准确度（90．45％）最高。结论血清标志物能较好地诊断肺癌，联合多种血清学指标检测可提高肺癌诊断的敏感度、准确度。Objective To study the clinical application of combined detection of CEA,ProGRP,NSE and CYFRA21-1 in diagnosis of lung cancer. Methods Fasting venous blood samples were collected from 133 cases with lung cancer,67 cases with benign pulmonary disease and 66 heahhy＇volunteers （control）, the serum level of CEA, ProGRP, NSE and CYFRA21-1 were detected by chemiluminescence method and the sensitivity rate, accuracy rate and specificity rate were calculate. Results The serum level of CYFRA21-1, CEA, NSE and ProGRP from lung cancer patients was 6.31 ± 1.04 ng/ml, 20.58 ± 2.41 ng/ml 32. 74±3.24 ng/ml and 125.78± 15.32 pg/ml,respectively. The level of CYFRA21-1 ,CEA,NSE,and ProGRP from benign pulmonary disease was 1.93±0.52 ng/mh2. 93＋=0. 82 ng/ml,10. 49±1.93 ng/ml and 48.32±6.72 pg/ml,respectively. The level of CYFRA21-1 ,CEA,ProGRP and NSE and from control was 2.67±0.74 ng/ml,35.78±4.2 pg/ml,8.34 ± 1.2 ng/ml and 1.56 ±0.45 ng/ml, respectively. The level of CEA, ProGRP,NSE and CYFRA21-1 from lung cancer were higher than that from benign pulmonary disease （t = 1.48 - 2.78, P = 0.13 - 0.25） and that from control （t = 1. 981 2. 371 ,P=0. 21-0.41） ,respectively,all of them was a statistical significance （P〈0.05）. The sensitivity rate of only CEA, ProGRP, NSE and CYFRA21-1 detection in diagnosis of lung cancer was 61.65 %, 45.86 %, 52.63% and 63.91%, respectively. The accuracy rate of only CEA, ProGRP, NSE and CYFRA21-1 detection was 72.36%, 63.81%, 67.34% and 74.87 %, respectively. Combining detection of two or three serum tumor markers in diagnosis of lung cancer, the sensitivity rate was 72% - 89% , the accuracy rate was 78.89% - 89.44% and the sensitivity rate （92.48%） and accuracy rate （90.45%） of combined detection of four serum tumor markers was the highest. Conclusion Serum markers can better diagnosis of lung cancer, combined detection of serum tumor markers can increase the sensitivity rate and accuracy rate in diagno- sis of lung cancer.

关 键 词：神经元特异性烯醇化酶 细胞角蛋白片段19 胃泌素释放前体 肺癌 诊断 

分 类 号：R734.2[医药卫生—肿瘤] R730.43[医药卫生—临床医学]