贵州医科大学学报

2017, v.42;No.202(07) 803-807

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血清CEA、NSE与CYFRA21-1联合检测在肺癌诊断及疗效评估中的价值
Value of Serum CEA,NSE and CYFRA21-1 Detection on Diagnosis and Efficacy Evaluation of Lung Cancer

丁珂;滕毅;
DING Ke;TENG Yi;Department of Laboratory,Clinic of Chinese PLA Naval Authority;Department of Laboratory,Kunming General Hospital of PLA;

摘要(Abstract):

目的:探讨血清中细胞角蛋白19片段(CYFRA21-1)、癌胚抗原(CEA)及神经元特异性烯醇化酶(NSE)联合检测在肺癌诊断及疗效评估中的价值。方法:53例肺癌患者为肺癌组(根据肺癌的不同类型又分为鳞肺癌组、腺癌组和小细胞肺癌组),53例肺良性疾病患者为肺良性疾病组,另选取53例同期体检健康者为对照组;两组肺疾病患者入院后第2天、对照组体检时取清晨空腹静脉血4 m L分离血清,以化学发光免疫法测定NSE水平,化学发光微粒子免疫检测法测定CYFRA21-1和CEA水平;比较3组被检者(两组肺疾病治疗前)血清CYFRA21-1、CEA及NSE表达水平,不同类型肺癌(鳞癌、腺癌、小细胞肺癌)患者的CYFRA21-1、CEA及NSE表达水平、不同临床疗效肺癌(疗效良好组和疗效较差组)患者的CYFRA21-1、CEA及NSE表达水平,分析CYFRA21-1、CEA及NSE单项或联合检测对诊断肺癌的灵敏度、特异度和准确度。结果:治疗前肺癌组CYFRA21-1、CEA及NSE表达水平高于治疗前肺良性疾病组与对照组,差异有统计学意义(P<0.05);腺癌组CEA水平高于鳞癌组及小细胞肺癌组,小细胞肺癌组NSE水平高于鳞癌组及腺癌组,差异有统计学意义(P<0.05);肺癌疗效良好组38例,疗效较差组15例,疗效良好组的CYFRA21-1、CEA及NSE水平低于疗效较差组,差异有统计学意义(P<0.05);CYFRA21-1、CEA及NSE联合检测对肺癌诊断的敏感度、准确度高于3项指标单独,差异有统计学意义(P<0.05)。结论:肺癌患者血清中NSE、CYFRA21-1与CEA水平异常增高,3项指标联合检测可提高肺癌诊断的敏感度与准确度,对鉴别肺癌类型及疗效评估具有一定价值。
Objective: To investigate the value of cytokeratin 19 fragment(CYFRA21-1),carcinoembryonic antigen( CEA) and neuron specific enolase( NSE) in the diagnosis and efficacy evaluation of lung cancer. Methods: Fifty-three patients with lung cancer( squamous cell carcinoma group,adenocarcinoma group and small cell lung cancer group) were selected as lung cancer group,53 patients with lung benign disease were selected as lung benign disease group and the other 53 healthy subjects were selected as control group,fasting venous blood were collected,level of NSE was determined by chemiluminescence immunoassay,and the levels of CYFRA21-1 and CEA were determined by chemiluminescence microparticle immunoassay. The serum levels of CYFRA21-1,CEA and NSE were compared between the 3 groups and among patients with different types of lung cancer and among patients with different curative effects. The sensitivity,specificity and accuracy of CYFRA21-1,CEA,NSE indiagnosis of lung cancer were analyzed. Results: The expression levels of CYFRA21-1,CEA and NSE in lung cancer group were higher than those in lung benig disease group and control group( P < 0.05). The level of CEA in the adenocarcinoma group was higher than that in squamous cell carcinoma group and small cell lung cancer group,and the level of NSE in small cell lung cancer group was higher than that in squamous cell carcinoma group and adenocarcinoma group( P < 0. 05). In 53 cases of lung cancer,the curative effect was good in 38 cases and poor in 15 cases. The CYFRA21-1,CEA and NSE levels in good curative effect group were lower than those in poor curative effect group( P <0. 05). The diagnostic sensitivity and accuracy of CYFRA21-1,CEA combined with NSE were higher than single CYFRA21-1,CEA or NSE( P < 0. 05). Conclusion: Serum NSE,CYFRA21-1 and CEA levels in patients with lung cancer are abnormally high,combined detection of the three indexes can improve the sensitivity and accuracy of lung cancer diagnosis,and distinguish lung cancer type,and has important assessment value for efficacy evaluation.

关键词(KeyWords): 肺肿瘤;癌胚抗原;诊断;神经元特异性烯醇化酶;细胞角蛋白19片段;疗效评估
lung cancer;carcinoembryonic antigen;diagnosis;neuron specific enolase;cytokeratin 19 fragment;efficacy evaluation

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作者(Author): 丁珂;滕毅;
DING Ke;TENG Yi;Department of Laboratory,Clinic of Chinese PLA Naval Authority;Department of Laboratory,Kunming General Hospital of PLA;

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