血清肿瘤标记物联合检测对晚期肺的临床意义.docVIP

医学论文免费下载 血清肿瘤标记物联合检测对晚期肺癌的临床意义 　　作者：张海琛 作者单位：大连医科大学附属二院肿瘤放疗科，辽宁 大连 116027 　　【摘要】 目的 探讨联合检测血清肿瘤标记物在晚期肺癌临床诊断及预后中的意义。方法 采用电化学发光法检测89例晚期肺癌病人血清CEA、NSE、CYFRA21-1的水平。结果 CEA、NSE、CYFRA21-1分别在腺癌、小细胞肺癌及鳞癌中呈高表达，其阳性率分别为77.78%、90.9%、80.95%，有统计学意义;CEA在Ⅲ、Ⅳ期肺癌中阳性率分别为44.11%、73.08%，有差异性。结论 三项肿瘤标记物联合检测晚期肺癌可提高诊断的灵敏度和准确性，并对肺癌的分型有一定的参考价值。而对于疗效及预后的判断可仅对某一阳性标记物进行长期动态监测。 　　【关键词】 癌胚抗原 神经特异性烯醇化酶 细胞角蛋白19片断 晚期肺癌 　　Clinical Significance of Three Serum Tumor Markers for Advanced Lung CancerZHANG Hai -chen, ZOU Li -juan (Oncology Radiotherapy Department, the Second Affiliated Hospital of Dalian Medical University, Dalian 116027 China) 【Abstract】 Objective To explore the significance of combined determination of serum tumor markers levels in the diagnosis and prognosis of advanced lung cancer. Methods The method of electrochemiluminescence was used to examine the combined determination of serum levels of CEA, NSE and CYFRA21-1 in 89 advanced lung cancer patients. Results The levels of CEA, NSE and CYFRA21-1 showed high expressions in adenocarcinoma, small cell lung cancer and squamous cell carcinoma patients, and the positive rates were 77.78%, 90.9%, 80.95% respectively, which had statistical significance. The positive rates of CEA in stage III and stage IV lung cancer were 44.11% and 73.08%, which are different. Conclusions The combined determination of serum tumor markers levels can increase the sensitivity and accuracy in lung cancer diagnosis, and have some reference value to this type of lung cancer. Only one of the positive markers can be a long-term dynamic monitoring for the therapy and prognosis of detection. 　　【Key words】 CEA;NSE;CYFRA21-1;advanced lung cancer 　　肺癌是世界范围内最常见也是导致死亡人数最多的恶性肿瘤[1]，临床上肺癌分为小细胞肺癌(small cell lung cancer,SCLS)和非小细胞肺癌(non-small cell lung cancer,NSCLC)，其中非小细胞肺癌约占肺癌总数的80%。我科2004年至今共收治肺癌病人557例，占所收治病人总数的30.62%，其中晚期(Ⅲ、Ⅳ期)肺癌占肺癌总数73.56%。肺癌血清标志物众多，单一指标检测的灵敏度及特异性均难满足临床对肺癌诊断、鉴别诊断、疗效及预后评估的要求，而多指标联合则能明显提高诊断的灵敏度及特异性，是标志物应用的趋势[2]。近年来国内研究表明癌胚抗原(CEA)、神经特异性烯醇化酶(NS