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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 value of tumor marker CEA, CA125, NSE and CYFRA21-1 in the serum of patients with lung cancer and to explore its value in the differential diagnosis of lung cancer. Methods 132 cases of lung cancer group, 87 cases of benign lung disease group and 86 cases of healthy control group were collected. Serum was obtained after treatment. The levels of four tumor markers were determined by Elecsys 2010 electrochemiluminescence assay. Tumor markers in the serum as well as the content of individual tests, combined detection of the sensitivity and specificity, and the test results using t-test statistical analysis. Results The serum levels of CEA, CA125, NSE and CYFRA21-1 in lung cancer group were significantly higher than those in benign lung disease group and normal control group, respectively (P <0.05). Lung benign lesion group and control group, serum CA125, CEA difference was statistically significant (P <0.05). The level of serum CEA in adenocarcinoma was significantly higher than that in small cell carcinoma (P <0.01). The serum level of CYFRA21-1 in squamous cell carcinoma was significantly higher than that in small cell carcinoma (P <0.05) and adenocarcinoma (P <0.05) Higher than adenocarcinoma and squamous cell carcinoma (P <0.01). The level of CA125 in adenocarcinoma was significantly higher than that in squamous cell carcinoma and small cell carcinoma (P <0.05). The positive rate of combined detection of four serum markers (97.0%) was significantly higher than the individual sensitivity. Conclusion CEA, CA125, NSE and CYFRA21-1 have certain diagnostic value for different types of lung cancer. Combined detection can greatly improve the sensitivity and is of great significance for the early diagnosis and differential diagnosis of lung cancer.