摘要
目的通过检测肿瘤标志物CEA、CA125、NSE、CYFRA21-1在肺癌患者血清中的水平,探讨其在肺癌鉴别诊断中的价值。方法采集肺癌组132例,肺良性病变组87例,健康对照组86例患者的静脉血,处理后得到血清,采用Elecsys 2010电化学发光法测定四项肿瘤标志物的水平,分析肺癌组中各肿瘤标志物在血清中的含量以及单项检测、联合检测的敏感性和特异性,并对检测结果用t检验法行统计分析。结果肺癌组CEA、CA125、NSE、CYFRA21-1血清水平分别明显高于肺良性病变组和正常对照组,差异有显著性意义(P<0.05)。肺良性病变组和对照组比较,血清CA125、CEA差异有统计学意义(P<0.05)。血清CEA水平腺癌明显高于小细胞癌(P<0.01);血清CYFRA21-1水平鳞癌明显高于小细胞癌(P<0.05)与腺癌(P<0.05);NSE水平小细胞癌明显高于腺癌和鳞癌(P<0.01);CA125水平腺癌明显高于鳞癌和小细胞癌(P<0.05)。四项血清标记物联合检测的阳性率(97.0%)显著高于各单项的敏感性。结论 CEA、CA125、NSE与CYFRA21-1对不同组织类型肺癌均有一定诊断价值,联合检测可大大提高灵敏度,对肺癌的早期诊断和鉴别具有重要意义。
Objective To investigate the clinical value of combined measurement of serum CYFRA21 - 1, NSE, CEA, CA19 - 9, CA125 for the diagnosis of lung cancer. Methods Collect the venous blood of 132 patients of pulmonary car- cinoma ,87 patients of pulmonary benign lesion and 86 health volunteers, and detect the level of CEA ,CA125 ,CYFRA21 - 1 and NSE in the serum by electro - chemil immunoassay. Then analyze their sensitivity and specificity of the single and combined test in tumor markers, and carry out the statistical analysis. Results The serum levels of CEA, CYFRA21 - 1 ,CA125 and NSE were significantly higher than that in those with benign lung disease and health volun- teers （P 〈 0.05 ）. There was a significant difference of the serum levels of CEA and CA125 between benign lung disease and health volunteers（P 〈0. 05）. The level of CEA in patients with glandular carcinoma was significantly higher than that with small - cell lung cancer（ P 〈 0. O1 ）. The level of CYFRA21 - 1 in patients with squamous - cell carcinoma was significantly higher than that in other subtypes （ P 〈 0. 05 ）. The level of NSE in patients with small - cell lung cancer was significantly higher than those in the other subtypes of lung cancer（ P 〈 0. 01 ）. The level of CA125 in patients with glan- dular carcinoma was significantly higher than that in other subtypes （ P 〈 0. 05 ）. The positive of combining test is 97. 0% ,that was obviously higher than only testing the single item. Conclusion CEA,CA125, NSE and CYFRA21 - 1 employed separately are helpful in the diagnosis of lung cancer. Combined determination of serum levels of CEA, CYFR21 -1, CA125 and NSE is valuable in differential diagnosis of lung cancers.
出处
《医药论坛杂志》
2014年第3期67-70,共4页
Journal of Medical Forum
