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目的:探讨血清肿瘤标志物神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段(Cyfra21-1)、糖类抗原199(CA199)、癌胚抗原(CEA)和乳酸脱氢酶(LDH)联合检测在诊断非小细胞肺癌(NSCLC)中的临床价值。方法:通过酶法和电化学发光方法分别检测283例NSCLC、192例肺良性病及207健康体检者的NSE、Cyfra21-1、CA199、CEA和LDH。结果:NSCLC组的NSE、Cyfra21-1、CA199、CEA和LDH 5项结果均高于肺良性病和健康体检者(P<0.05);在NSCLC病理分型中,CEA在腺癌者中表达水平明显高于鳞癌者,鳞癌者的Cyfra21-1含量高于腺癌者(P<0.05);TNM分期T1/T2期的NSE、Cyfra21-1、CEA和LDH 4种肿瘤标志物表达水平均明显低于T3/T4期,临床分期Ⅰ/Ⅱ期的NSE、Cyfra21-1、CA199、CEA和LDH含量均显著低于Ⅲ/Ⅳ期(P<0.05);联合检测的阳性结果和敏感度均显著高于单项检测(P<0.05);Cyfra21-1和CEA对NSCLC诊断效能最高,CEA和Cyfra21-1分别对肺腺癌和肺鳞癌诊断效能最高。结论:NSE、Cyfra21-1、CA199、CEA和LDH 5种肿瘤标志物在NSCLC患者中异常高表达,且与NSCLC的临床分期和TNM分期呈正相关,联合检测能提高NSCLC的诊断效能,显著提高诊断灵敏度和特异性,对NSCLC的早期诊断、治疗监测和预后判断具有重要的参考价值。
Objective: To investigate the relationship between serum tumor markers such as neuron-specific enolase (NSE), Cyfra21-1, carbohydrate antigen 199 (CA199), carcinoembryonic antigen (CEA) and lactate dehydrogenase ) Combined detection in the diagnosis of non-small cell lung cancer (NSCLC) clinical value. Methods: NSE, Cyfra21-1, CA199, CEA and LDH were detected in 283 patients with NSCLC, 192 patients with benign lung disease and 207 healthy subjects by enzymatic and chemiluminescent methods respectively. Results: The results of NSF, Cyfra21-1, CA199, CEA and LDH in NSCLC group were higher than those in benign and healthy subjects (P <0.05). In NSCLC, the expression of CEA in adenocarcinoma The levels of Cyfra21-1 in squamous cell carcinoma were significantly higher than those in adenocarcinoma (P <0.05). The expression levels of NSE, Cyfra21-1, CEA and LDH in T1 / T2 TNM stage were significantly higher than those in squamous cell carcinoma The levels of NSE, Cyfra21-1, CA199, CEA and LDH in stage Ⅰ / Ⅱ were significantly lower than those in stage Ⅲ / Ⅳ (P <0.05). The positive results and sensitivity (P <0.05). Cyfra21-1 and CEA had the highest diagnostic efficacy for NSCLC, and CEA and Cyfra21-1 had the highest diagnostic efficacy for lung adenocarcinoma and lung squamous cell carcinoma, respectively. CONCLUSIONS: The five tumor markers of NSE, Cyfra21-1, CA199, CEA and LDH are highly expressed in NSCLC patients, and are positively correlated with the clinical stage and TNM stage of NSCLC. Combined detection can improve the diagnostic efficacy of NSCLC and significantly improve the diagnosis Sensitivity and specificity of NSCLC early diagnosis, treatment monitoring and prognosis have important reference value.