Abstract
目的 探讨联合检测血清中肿瘤标记物CYFRA21-1、NSE对肺癌早期诊断、病情监测及疗效判定的价值.方法 将肺癌患者分为非小细胞肺癌组(NSCLC)和小细胞肺癌组(SCLC),以健康人及肺部良性病变患者(BLD)为对照组.静脉取血,采用免疫放射法(IRMA)、放射免疫法(RIA)分别检测血清CYFRA21-1和NSE.结果 血清CYFRA21-1水平在NSCLC组明显高于SCLC和BLD组(P＜0.01),其对NSCLC诊断的阳性率显著高于SCLC组(58.1%vs 16.7%,P＜0.01).NSE则在SCLC组明显高于NSCLC和BLD组(P＜0.01),其对SCLC诊断的阳性率为66.7%,显著高于NSCLC组24.3%(P＜0.01).血清CYFRA21-1、NSE联合检测与各单项指标相比,可将肺癌诊断的敏感度、特异度和阳性率分别提高到79.1%、91.7%和85.0%(P＜0.01).此外,在NSCLC组,血清CYFRA21-1含量变化与肿瘤分期呈正相关,且与患者病情的变化有相关性.结论 联合检测血清中CYFRA21-1、NSE水平可明显提高肺癌早期诊断的阳性率,从而提高肺癌的早期诊断.临床上动态监测血清CYFRA21-1水平对NSCLC的进程及疗效判断有一定的价值。
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