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目的:评价癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、鳞状细胞癌抗原(SCC)、糖链抗原125(CA125)和细胞角蛋白19片断(CYFRA21-1)对肺癌诊断的临床价值。方法:用化学发光免疫分析法测定103例肺癌、85例良性疾病和60健康对照血清CEA、NSE、SCC、CA125和CYFRA21-1水平。评价它们对肺癌的诊断价值。结果:肺癌患者血清CEA、NSE、SCC、CA125和CYFRA21-1水平显著高于良性疾病与健康对照(P<0.05)。腺癌患者血清CEA和CA125的水平及阳性率都显著高于鳞癌和小细胞癌(P<0.05),肺鳞癌患者血清CYFRA21-1和SCC的水平及阳性率显著高于腺癌和小细胞癌(P<0.05),小细胞肺癌患者血清NSE水平及阳性率显著高于腺癌和鳞癌(P<0.05)。五种肿瘤标志物单项检测的阳性率小于50%。在肿瘤标志物联合试验中,以CEA+NSE联合、CEA+NSE+CYFRA21-1联合、CEA+NSE+CYFRA21-1+CA125联合为最佳,它们对肺癌的阳性率分别为65.3%、70.9%和71.8%。结论:血清CEA、NSE、SCC、CYFRA21-1和CA125的水平和阳性率与肺癌的病理类型有关。肿瘤标志物联合检测可提高对肺癌的诊断灵敏度,首选CEA、NSE和CYFRA21-1三种肿瘤标志物联合。
Objective: To evaluate the effect of carcinoembryonic antigen (CEA), neuron specific enolase (NSE), squamous cell carcinoma antigen (SCC), carbohydrate antigen 125 (CA125) and cytokeratin 19 (CYFRA21-1) The clinical value of diagnosis. Methods: The levels of serum CEA, NSE, SCC, CA125 and CYFRA21-1 in 103 cases of lung cancer, 85 cases of benign disease and 60 healthy controls were determined by chemiluminescence immunoassay. Evaluate their diagnostic value of lung cancer. Results: The serum levels of CEA, NSE, SCC, CA125 and CYFRA21-1 in patients with lung cancer were significantly higher than those in benign diseases and healthy controls (P <0.05). The levels and positive rates of serum CEA and CA125 in patients with adenocarcinoma were significantly higher than those in squamous cell carcinoma and small cell carcinoma (P <0.05). The levels and positive rates of serum CYFRA21-1 and SCC in patients with lung squamous cell carcinoma were significantly higher than those in adenocarcinoma and small cell lung cancer (P <0.05). The serum level of NSE and the positive rate of NSE in patients with small cell lung cancer were significantly higher than those in adenocarcinoma and squamous cell carcinoma (P <0.05). The positive rates of single detection of five tumor markers were less than 50%. The combination of CEA + NSE, CEA + NSE + CYFRA21-1 and CEA + NSE + CYFRA21-1 + CA125 were the best combination in the combination of tumor markers. The positive rates of them were 65.3%, 70.9% And 71.8%. Conclusion: The levels and positive rates of serum CEA, NSE, SCC, CYFRA21-1 and CA125 are related to the pathological types of lung cancer. Tumor markers combined detection can improve the diagnostic sensitivity of lung cancer, the preferred CEA, NSE and CYFRA21-1 three tumor markers combined.