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目的 :评价进展期肺癌患者血清癌胚抗原 (CEA)、神经元特异性烯醇化酶 (NSE)、细胞角蛋白19片段 (CYFRA2 1 1)水平在肺癌诊断、确定病理类型和病情评估方面的临床价值。方法 :采用生物素酶免法测定 79例ⅢA、ⅢB、Ⅳ期原发性肺癌和术后复发或转移患者血清CEA、NSE、CYFRA2 1 1水平。结果 :79例进展期肺癌患者治疗前CEA、NSE、CYFRA2 1 1明显高于正常对照组。 3项联合检测阳性率达 97 5 %。鳞癌组、腺癌组和小细胞未分化癌组之间肿瘤标记物水平差异有显著性。CEA水平以腺癌组最高 ,NSE水平以小细胞未分化癌组最高 ,CYFRA2 1 1水平以鳞癌组最高。化疗有效者肿瘤标记物水平降低 ,病情进展和肿瘤转移患者则升高。结论 :CEA、NSE、CYFRA2 1 1联合用于肺癌的诊断有极高的特异性和敏感性 ,NSE CYFRA2 1 1与肺癌的病理类型有很好的相关性 ,为无法做病理学检查的患者的治疗提供支持 ,此外在病情监测和疗效判断方面可为临床提供有价值的资料
Objective: To evaluate the clinical value of serum carcinoembryonic antigen (CEA), neuron-specific enolase (NSE) and cytokeratin 19 (CYFRA211) levels in patients with advanced lung cancer in the diagnosis of lung cancer, determination of pathological types, and assessment of disease status value. Methods : Serum levels of CEA, NSE, and CYFRA2 11 in patients with stage IIIA, IIIB, and IV primary lung cancer and postoperative recurrence or metastasis were determined by biotinase immunoassay. Results: The pretreatment CEA, NSE, CYFRA211 in 79 patients with advanced lung cancer were significantly higher than those in the normal control group. The positive rate of three joint tests reached 97.5%. There were significant differences in the levels of tumor markers between the squamous cell carcinoma, adenocarcinoma and small cell undifferentiated cancer groups. CEA levels were highest in the adenocarcinoma group, NSE levels were highest in the small-cell undifferentiated carcinoma group, and CYFRA211 levels were highest in the squamous cell carcinoma group. The level of tumor markers was reduced in patients who responded to chemotherapy, and the progression of disease and tumor metastases increased. Conclusion: CEA, NSE, and CYFRA211 have a high specificity and sensitivity in the diagnosis of lung cancer. NSE CYFRA211 has a good correlation with the pathological type of lung cancer, and it is not suitable for pathological examination of patients. Therapeutics provide support. In addition, it can provide valuable clinical information in terms of disease monitoring and efficacy assessment.