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目的:探讨联合检测肿瘤标志物CYFRA21-1、NSE和CEA在肺腺癌、肺鳞癌及小细胞肺癌的诊断性价值。方法:采用化学发光法对45例肺腺癌、42例肺鳞癌及43例小细胞肺癌患者血清中的CYFRA21-1、NSE和CEA进行检测。结果:在肺癌患者的CYFRA21-1检测中,肺鳞癌组的含量最高,肺腺癌组次之,小细胞肺癌患者最低,三组比较差异有统计学意义(F=5.842,P<0.05),而CYFRA21-1的检测水平则与肺癌TNM分期无明显相关性(P>0.05)。在肺癌患者的NSE检测中,小细胞肺癌组的含量最高,为(18.76±12.31)ng/ml(P<0.01),而肺腺癌和肺鳞癌的含量则无明显差别(P>0.05),且NSE在肺癌Ⅰ/Ⅱ期的含量明显高于Ⅲ/Ⅳ期(P<0.05)。在肺癌患者的CEA检测中,肺腺癌的含量高达(89.45±34.58)ng/ml,显著高于肺鳞癌组和小细胞肺癌组(P<0.01),且CEA在肺癌Ⅲ/Ⅳ期的含量明显高于Ⅰ/Ⅱ期(P<0.05)。三项联合检测与其他单项检测及两项联合检测相比,特异性下降幅度不明显(P>0.05),而敏感度和准确性进一步分别提升至80.00%和81.97%,差异有统计学意义(P<0.05)。结论:联合检测肿瘤标志物CYFRA21-1、NSE和CEA可提高检测肺癌的敏感度和准确度,同时为无法进行病理检查肺癌患者的诊断、分型、分期提供可靠的参考依据。
Objective: To investigate the diagnostic value of combined detection of tumor markers CYFRA21-1, NSE and CEA in lung adenocarcinoma, lung squamous cell carcinoma and small cell lung cancer. Methods: The serum levels of CYFRA21-1, NSE and CEA in 45 patients with lung adenocarcinoma, 42 patients with squamous cell carcinoma and 43 patients with small cell lung cancer were determined by chemiluminescence method. Results: In lung cancer patients, CYFRA21-1 was the highest in lung squamous cell carcinoma, followed by lung adenocarcinoma, and the lowest in small cell lung cancer. There was significant difference among the three groups (F = 5.842, P <0.05) , While the detection level of CYFRA21-1 had no significant correlation with TNM staging of lung cancer (P> 0.05). In the NSE of lung cancer patients, the content of small cell lung cancer was the highest (18.76 ± 12.31) ng / ml (P <0.01), while there was no significant difference between lung adenocarcinoma and lung squamous cell carcinoma (P> 0.05) , And the content of NSE in stage Ⅰ / Ⅱ of lung cancer was significantly higher than that in stage Ⅲ / Ⅳ (P <0.05). In patients with lung cancer, the level of lung adenocarcinoma was as high as 89.45 ± 34.58 ng / ml, significantly higher than that in lung squamous cell carcinoma and small cell lung cancer (P <0.01), and CEA was found in stage Ⅲ / Ⅳ Content was significantly higher than Ⅰ / Ⅱ (P <0.05). Compared with other single tests and the two combined tests, the three combined tests showed no significant decrease (P> 0.05), while the sensitivity and accuracy were further increased to 80.00% and 81.97%, respectively, with significant differences (P < P <0.05). Conclusion: The combined detection of tumor markers CYFRA21-1, NSE and CEA can improve the sensitivity and accuracy of detection of lung cancer, and provide a reliable reference for the diagnosis, classification and staging of lung cancer patients who can not be pathologically examined.