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目的 探讨CYFRA21－1对肺癌的诊断、疗效监测和预后判断价值。方法 采用酶免疫分析（EIA）方法对111例经病理确诊的肺癌和62例非癌对照组血清CYFRA21－1进行测定，阈值为3．3μg／L。结果 肺癌组CYFRA21－1浓度为6．1μg／L，显著高于对照组的1．6μg／L（P＜0．001），肺癌组和对照组CYERA21－1阳性率分别为80．2％和6．5％，诊断特异性93．5％。NSCLC组CYERA21－1阳性率86．4％，显著高于SCLC组（P＜O．01）。血清CYFRA21－1浓度随肺癌分期升高而增加（P＜0．05）。对37例接受手术和12例接受化疗的病人血清CYERA21－1变化分析显示，手术病人血清值由术前的6．2μg／L降到术后2．2μg／L（P＜0．001）；6例化PR者由治疗前的5．0μg／L降至2．4μg／L。6例化疗无效进展者，血清值也相应增加。13例肺癌病人CYFRA21－1动态观察显示，肿瘤情况的变化也常伴随着CYFRA21－1的相应变化。 结论 血清CYFRA21－1水平在肺癌中显著增加，并随病情变化而改变。CYFRA21－1测定有助于肺癌诊断、疗效监测和病情变化的判断。
Objective To investigate the value of CYFRA21-1 in the diagnosis, therapeutic monitoring and prognosis of lung cancer. Methods Enzyme immunoassay (EIA) was used to detect the serum CYFRA21-1 in 111 cases of pathologically confirmed lung cancer and 62 cases of non-cancerous controls. The threshold value was 3.3μg/L. Results The concentration of CYFRA21-1 in lung cancer group was 6.1μg/L, which was significantly higher than that in control group (1.6μg/L, P<0.001). The positive rate of CYFRA21-1 in lung cancer group and control group was 80.2% respectively. 6.5%, diagnostic specificity 93.5%. The positive rate of CYERA21-1 was 86.4% in the NSCLC group, which was significantly higher than that in the SCLC group (P<0.01). Serum CYFRA21-1 concentration increased with the increase of lung cancer staging (P<0.05). The analysis of serum CYERA21-1 changes in 37 patients undergoing surgery and 12 patients undergoing chemotherapy showed that the serum value of the surgical patients decreased from 6.2 μg/L before surgery to 2.2 μg/L after surgery (P<0.001). The number of patients with 6 cases of PR decreased from 5.0 μg/L before treatment to 2.4 μg/L. Six cases of progress of chemotherapy failure, serum levels also increased. The dynamic observation of CYFRA21-1 in 13 lung cancer patients showed that the changes in tumor status were often accompanied by the corresponding changes in CYFRA21-1. Conclusion Serum CYFRA21-1 levels increase significantly in lung cancer and change with the condition. The determination of CYFRA21-1 is helpful for the diagnosis of lung cancer, the monitoring of therapeutic effect and the judgment of the change of the disease.