文章摘要
徐一凯,陈素珍,胡丹丹,王世强,章潜,楼黎明.肿瘤标志物神经特异性烯醇化酶与糖链抗原125及血清细胞角蛋白19片段和癌胚抗原在肺癌诊断与分期中的价值[J].中国临床保健杂志,2017,20(5):498-501.
肿瘤标志物神经特异性烯醇化酶与糖链抗原125及血清细胞角蛋白19片段和癌胚抗原在肺癌诊断与分期中的价值
Value of tumor markers CYFRA21-1,NSE and CEA in the diagnosis and staging of lung cancer
投稿时间:2017-06-26  
DOI:10.3969/J.issn.1672-6790.2017.05.005
中文关键词: 肺肿瘤  抗原,肿瘤相关,碳水化合物  角蛋白19  癌症早期检测
英文关键词: Lung neoplasms  Antigens,tumor-associated,carbohydrate  Keratin-19  Early detection of cancer〖FL
基金项目:浙江省中医药科技计划项目(2016ZA111)
作者单位E-mail
徐一凯 浙江中医药大学附属第三医院呼吸科,杭州 310053 zjzyxyk@163.com 
陈素珍 浙江中医药大学附属第三医院呼吸科,杭州 310053  
胡丹丹 浙江中医药大学附属第三医院呼吸科,杭州 310053  
王世强 浙江中医药大学附属第三医院呼吸科,杭州 310053  
章潜 浙江中医药大学附属第三医院呼吸科,杭州 310053  
楼黎明 浙江中医药大学附属第三医院呼吸科,杭州 310053  
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中文摘要:
      目的 探讨肿瘤标志物神经特异性烯醇化酶(NSE)、糖链抗原125 (CA125)、血清细胞角蛋白19片段(CYFRA21-1)、癌胚抗原(CEA)的检测在肺癌诊断与分期中的应用价值。方法 选择确诊的65例肺癌患者,设为肺癌组;65例肺部良性疾病患者,设为良性组;65例同期健康体检者,设为对照组。统计血清肿瘤标志物[CYFRA21-1、CA125、NSE、CEA]检出水平;统计肺癌组不同病理分型CYFRA21-1、CA125、NSE、CEA的检出情况;统计各肿瘤标志物单独诊断及联合诊断肺癌的敏感性、特异性及准确度。结果 肺癌组CYFRA21-1、CA125、NSE、CEA水平为(15.49±4.52)μg/L、(88.80±14.17)μg/L、(43.51±9.17)μg/L、(10.87±4.33)μg/L,明显高于良性组的(3.85±1.82)μg/L、(22.16±4.12)μg/L、(12.38±3.44)μg/L、(4.01±1.12)μg/L (P<0.05),且明显高于小细胞癌组的(1.32±0.52) μg/L、(13.11±1.68) μg/L、(5.19±2.11) μg/L、(1.04±0.54) μg/L (P<0.05);良性组CYFRA21-1、CA125、NSE、CEA血清浓度明显高于对照组(P<0.05)。腺癌组CA125、CEA水平为(192.46±9.67) μg/L、(19.15±3.28) μg/L,明显高于鳞癌组的(38.86±8.82) μg/L、(7.33±1.78) μg/L (P<0.05),且明显高于小细胞癌组的(41.66±8.45) μg/L、(6.21±1.29) μg/L (P<0.05);腺癌组CYFRA21-1、NSE水平为(6.28±1.22) μg/L、(22.85±4.19) μg/L,明显低于鳞癌组(26.33±6.19) μg/L、(32.65±7.12) μg/L (P<0.05),且明显低于小细胞癌组(9.25±2.84) μg/L、(89.62±11.37) μg/L (P<0.05);鳞癌组CYFRA21-1血清浓度高于小细胞癌组(P<0.05),NSE血清浓度低于小细胞癌组(P<0.05)。联合检测CYFRA21-1、CA125、NSE、CEA的敏感性和准确度为91.75%、94.87%,分别高于单独检测值。结论 CYFRA21-1、CA125、NSE、CEA等肿瘤标志物水平在肺癌患者血清中异常增高,单独检测可辅助诊断肺癌以及进行病理分型,联合检测能提高肺癌早期诊断的准确度和敏感性。
英文摘要:
      Objective To investigate the value of tumor markers CYFRA21-1,CA125,NSE and CEA in the diagnosis and staging of lung cancer. Methods 65 patients with lung cancer diagnosed and treated in our hospital were enrolled as lung cancer group,65 patients with benign lung disease were enrolled as lung benign group,and 65 healthy people were enrolled as control group.The tumor markers[nerve specific enolase (NSE),sugar chain antigens 125 (CA125),cytokeratin 19 fragment (CYFRA21-1),carcinoembryonic antigen (CEA)]levels were collected. The CYFRA21-1,CA125,NSE and CEA levels of pathological types in lung cancer group were collected. The sensitivity,specificity and accuracy of tumor markers alone and combined in the diagnosis of lung cancer were analyzed. Results CYFRA21-1,CA125,NSE and CEA levels of lung cancer group were (15.49±4.52) μg/L,(88.80±14.17) μg/L,(43.51±9.17) μg/L,(10.87±4.33) μg/L,which were significantly higher than those of benign group [(3.85±1.82) μg/L,(22.16±4.12) μg/L,(12.38±3.44) μg/L,(4.01±1.12) μg/L] (P<0.05),and significantly higher than those of control group [(1.32±0.52) μg/L,(13.11±1.68) μg/L,(5.19±2.11) μg/L,(1.04±0.54) μg/L] (P<0.05). CYFRA21-1,CA125,NSE and CEA levels of benign group were significantly higher than those of control group (P<0.05). CA125 and CEA levels of adenocarcinoma group were (192.46±9.67) μg/L,(19.15±3.28) μg/L,which were significantly higher than those of squamous cell carcinoma group [(38.86±8.82) μg/L,(7.33±1.78) μg/L] (P<0.05),and were significantly higher than those of small cell carcinoma group [(41.66±8.45) μg/L,(6.21±1.29) μg/L] (P<0.05). CYFRA21-1 and NSE levels of adenocarcinoma group were (6.28±1.22) μg/L,(22.85±4.19) μg/L,which were significantly lower than those of squamous cell carcinoma group [(26.33±6.19) μg/L,(32.65±7.12) μg/L] (P<0.05),and were significantly lower than those of small cell carcinoma group [(9.25±2.84) μg/L,(89.62±11.37)μg/L] (P<0.05). The sensitivity and accuracy of combined detection of CYFRA21-1,CA125,NSE and CEA were 91.75% and 94.87%,which were higher than those of single detection. Conclusion The serum CYFRA21-1,CA125,NSE,CEA levels are abnormally increased in patients with lung cancer. Individual detection can help diagnose lung cancer and pathological type and combined detection can improve the accuracy and sensitivity of early diagnosis of lung cancer.
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