目的　通过胸水CYFRA2 1 1(细胞角蛋白片段 )、CEA(癌胚抗原 )及NSE(神经烯醇化酶 )的检测 ,探讨各指标对肺癌诊断特异性及联合分析对肺癌的诊断价值和临床意义。方法　对 12 3例肺良性疾病组患者和 15 6例肺癌组患者胸水进行上述肿瘤标志物测定。将肺癌患者又根据病理类型分成腺癌组 (81例 )、鳞癌组 (5 0例 )、小细胞癌组 (12例 )和未定性癌组 (13例 )对各指标分别进行对照分析。结果　肺癌组胸水CYFRA2 1 1、CEA及NSE含量 (ng/ml)分别为 5 5 34± 37 44、5 7 11± 5 2 6 5及 16 99± 2 9 2 2 ,而肺良性疾病组的含量则分别为 9 0 8± 7 5 4、9 92± 6 2 8和 7 30±6 2 9,各指标的统计学检验均有极显著差异 (P <0 0 0 1)。CYFRA2 1 1在肺鳞癌组最高 ,与小细胞肺癌组相比有显著差异 (P <0 0 5 ) ,而与腺癌组和未定型癌组相比无显著差异 (P <0 0 5 ) ;CEA主要在腺癌组的含量均比其他肺癌组有极明显增高 (P <0 0 0 1) ;NSE则在小细胞癌组最高 ,其含量与其他肺癌组相比有极明显增加 (P <0 0 0 1)。结论　胸水CYFRA2 1 1,CEA及NSE在不同组织类型肺癌中的含量明显不同 ;三者联合测定对肺癌的诊断有重要的临床参考价值 Objective To investigate the diagnostic value and clinical significance of the diagnostic specificity and combined analysis of each index for lung cancer by detecting the cytokeratin CYFRA2 1 1 (cytokeratin fragment), CEA (carcinoembryonic antigen) and NSE (neuroenoenolase). Methods Tumor markers were measured in pleural effusion in 123 patients with benign lung disease and in 15 6 patients with lung cancer. The lung cancer patients were divided into adenocarcinoma group (81 cases), squamous cell carcinoma group (50 cases), small cell carcinoma group (12 cases) and unfractured carcinoma group (13 cases) according to pathological type. Results The pleural fluid CYFRA2 1 1, CEA and NSE (ng / ml) of lung cancer group were respectively 5 5 34 ± 37 44,5 7 11 ± 5 2 6 5 and 16 99 ± 2 9 2 2, while the content of benign lung disease group Respectively, which were respectively 9 0 8 ± 7 5 4, 9 92 ± 6 2 8 and 7 30 ± 6 2 9. There was a significant difference (P <0.01 01) in the statistical test of each index. CYFRA2 1 1 was the highest in squamous cell carcinoma of the lung and significantly different from that in the small cell lung cancer (P <0.05), but not significantly different from that in the adenocarcinoma and the untreated carcinoma (P <0.05) ; The content of CEA in adenocarcinoma group was significantly higher than that in other lung cancer group (P <0.01); NSE was the highest in small cell carcinoma group, and its content was significantly increased compared with other lung cancer group (P <0 0 0 1). Conclusions The contents of CYFRA2 1 1, CEA and NSE in pleural effusion are significantly different in different types of lung cancer. The combination determination of the three has important clinical value in the diagnosis of lung cancer