5种肿瘤标志物在肺癌早期诊断中的临床应用研究

摘要

目的：评价癌胚抗原(CEA)、细胞角蛋白19片段（CYFRA21-1）、糖类抗原CA-125、CA-242、神经原特异性烯醇化酶(NSE)五种肿瘤标志物在肺癌早期诊断中的临床价值。方法回顾性分析708例住院病人5项血清肿瘤标志物水平和临床病理资料。结果肺癌5种血清肿瘤标志物阳性检出率明显高于与肺良性疾病,差异有统计学意义（P<0．05）；鳞癌、腺癌、小细胞癌阳性检出率分别是CYFRA21-1、（CEA、CA-242）、NSE最高，相比其他标志物均有统计学意义（P<0．05）。腺癌CEA、CA-125、CA-242肿瘤标志物水平明显高于鳞癌、小细胞肺癌(P<0．05)，鳞癌CYFRA21-1水平明显高于腺癌、小细胞肺癌(P<0．05)；小细胞肺癌NSE水平明显高于腺癌、鳞癌（P<0．05）。肿瘤标志物水平与肺癌临床分期相关,标志物水平越高,分期越晚。结论 CEA、CYFRA21-1、CA-125、CA-242及NSE仍是诊断肺癌的重要肿瘤标志物,鳞癌、腺癌、小细胞肺癌的实验室诊断可分别优先选择CYFRA21-1,CEA、CA-242,NSE。%Objective To evaluate the clinical value of 19 tumor markers in the early diagnosis of lung cancer by evaluating the five kinds of tumor markers(CEA),CYFRA21-1,CA-125 ,CA-242 and NSE. Methods Retrospective analysis of 708 cases of hospitalized patients with 5 serum tumor markers level and clinical pathology data.Results The positive detection rate of 5 serum tumor markers in lung cancer was significantly higher than that in benign lung disease (P<0.05). The positive rate of squamous cell carcinoma, adenocarcinoma, small cell carcinoma was CYFRA21-1, (CEA,CA-242)and NSE was the highest, compared with other markers(P<0.05). The levels of CEA, CA-125 and CA-242 were significantly higher than those of squamous cell carcinoma and small cell lung cancer (P<0.05), and the level of CYFRA21-1 was significantly higher than that of ade-nocarcinoma and small cell lung cancer (P<0.05). The level of NSE in small cell lung cancer was significantly higher than that of adenocarcinoma and squamous cell carcinoma (P<0.05). Tumor markers were associated with clinical stages of lung cancer, and the higher the level of markers, the later stage of staging.Conclusions CEA,CYFRA21-1,CA-242,NSE and CA-125 were still im-portant tumor markers in diagnosis of lung cancer, the laboratory diagnosis of squamous cell car-cinoma, adenocarcinoma, small cell lung cancer, CYFRA21-1,CEA,CA-242,NSE.