【摘要】 目的研究血清癌胚抗原(CEA)和细胞角蛋白19片段(CYFRA21-1)检测对非小细胞肺癌(NSCLC)临床诊断的临床价值。方法选取85例NSCLC患者,根据癌症类型不同分为肺腺癌组(肺腺癌,53例)、肺鳞癌组(肺鳞癌,28例)、肺大细胞癌组(肺大细胞癌,4例);另选取30例正常健康体检者作为对照组。所有研究对象均采用电化学发光法对血清CEA和CYFRA21-1进行检测,比较各组血清CEA、CYFRA21-1浓度及其阳性率,并观察不同临床分期肺癌患者血清CEA、CYFRA21-1浓度及其阳性率的差异。结果肺腺癌组、肺鳞癌组、肺大细胞癌组血清CEA及CYFRA21-1浓度均明显高于对照组(P<0.05);肺腺癌组血清CEA浓度明显高于肺鳞癌组和肺大细胞癌组(P<0.05);肺鳞癌组CYFRA21-1浓度明显高于肺腺癌组及肺大细胞癌组(P<0.05);肺腺癌组、肺鳞癌组、肺大细胞癌组血清CEA及CYFRA21-1单项及联合检测阳性率均明显高于对照组(P<0.05);三组患者中,血清CEA检测阳性率肺腺癌组最高,CYFRA21-1检测阳性率肺鳞癌组最高,联合检测阳性率肺大细胞癌组最高。NSCLC患者中,Ⅰ、Ⅱ期血清CEA浓度与Ⅲa、Ⅲb、Ⅳ期比较差异具有统计学意义(P<0.05),而Ⅰ期血清CEA浓度(2.75±1.31)ng/ml与Ⅱ期的(3.83±2.35)ng/ml比较差异无统计学意义(P>0.05);Ⅰ、Ⅱ、Ⅲa期CYFRA21-1浓度均明显低于Ⅲb、Ⅳ期(P<0.05),Ⅰ期、Ⅱ期、Ⅲa期CYFRA21-1浓度两两比较差异无统计学意义(P>0.05)。Ⅲa期以后,CEA指标和CYFRA21-1浓度均急剧增高,且其阳性率随分期增高,也呈渐趋增高显示。结论针对临床收治的NSCLC患者,对血清CEA指标与CYFRA21-1指标行精准检测,可为临床诊断、病变分期、预后评估提供重要参考依据,开展价值显著。更多还原

【Abstract】 Objective To study the clinical value of serum carcinoembryonic antigen(CEA) and cytokeratin 19 fragment(CYFRA21-1) detection in diagnosis of non-small cell lung cancer(NSCLC). Methods A total of 85 NSCLC patients were divided by different types of cancer into lung adenocarcinoma group(lung adenocarcinoma, 53 cases), lung squamous cell carcinoma group(lung squamous cell carcinoma, 28 cases), lung large cell carcinoma group(lung large cell carcinoma, 4 cases). Another 30 healthy subjects were selected as control group. The serum CEA and CYFRA21-1 were detected by electrochemiluminescence, and the serum levels of CEA, CYFRA21-1 and the positive rate were compared between groups. The differences of serum CEA, CYFRA21-1 concentration and positive rate were observed in different clinical stages of lung cancer patients. Results Lung adenocarcinoma group, lung squamous cell carcinoma group and lung large cell carcinoma group had obviously higher concentration of serum CEA and CYFRA21-1 than the control group(P<0.05). Lung adenocarcinoma group had obviously higher concentration of serum CEA than lung squamous cell carcinoma group and lung large cell carcinoma group(P<0.05). Lung squamous cell carcinoma group had obviously higher concentration of CYFRA21-1 than lung adenocarcinoma group and lung large cell carcinoma group(P<0.05). Lung adenocarcinoma group, lung squamous cell carcinoma group and lung large cell carcinoma group had obviously higher positive rate of single and combined detection of serum CEA and CYFRA21-1 than the control group(P<0.05). Among the three groups, the positive rate of serum CEA was the highest in the lung adenocarcinoma group. The positive rate of CYFRA21-1 was the highest in the lung squamous cell carcinoma group, and the combined detection positive rate was the highest in the lung large cell carcinoma group. In patients with NSCLC, there was a statistically significant difference in concentration of serum CEA at phase Ⅰ and Ⅱ compared with phase Ⅲa, Ⅲb and Ⅳ(P<0.05). There was no statistically significant difference in concentration of serum CEA at phase I as(2.75±1.31) ng/ml, comparing with(3.83±2.35) ng/ml at phase Ⅱ(P>0.05). The concentration of CYFRA21-1 at phase Ⅰ, Ⅱ, Ⅲa was obviously lower than that of phase Ⅲb and Ⅳ(P<0.05). There was no statistically significant difference in concentration of CYFRA21-1 among phase Ⅰ, Ⅱ, Ⅲa(P>0.05). After Ⅲa, the concentration of CEA index and CYFRA21-1 increased sharply, and the positive rate increased gradually with the increase of phase. Conclusion Accurate detection of serum CEA index and CYFRA21-1 index can provide important reference for clinical diagnosis, pathological staging and prognosis evaluation for clinical NSCLC patients. This method contains significant value.更多还原