摘要
目的探讨神经特异性烯醇化酶(NSE)、细胞角蛋白19片段(CYFRA21-1)、血小板源性生长因子(PDGF-BB)和D-二聚体(D-D)4种参数联合检测在肺癌患者中的临床意义。方法采用化学发光法对肺癌组(69例)、肺良性疾病组(48例)和正常对照组(65名)的血清NSE、CYFRA21-1进行检测,采用酶联免疫吸附试验(ELISA)对血清PDGF-BB进行检测,采用免疫比浊法对血浆D-D进行检测,对肺癌患者NSE、CYFRA21-1、PDGF-BB和D-D水平与临床分期关系进行统计学分析。结果肺癌组血清NSE、CYFRA21-1、PDGF-BB和D-D明显高于肺良性疾病组和正常对照组(P均<0.01)。CYFRA21-1在肺鳞癌中的水平最高,NSE在小细胞肺癌中的水平最高,与其他肺癌组比较,差异均有统计学意义(P均<0.05)。单项参数在肺癌诊断中的敏感性:NSE>CYFRA21-1>PDGF-BB>D-D。在鳞癌中CYFRA21-1敏感性最高(72.4%),小细胞肺癌中NSE敏感性最高(66.7%)。NSE、CYFRA21-1、PDGF-BB和D-D联合检测可以明显提高肺癌诊断的敏感性和准确性。在肺癌诊断中NSE、CYFRA21-1、PDGF-BB和D-D组合敏感性最高(89.9%),准确性最高(86.3%),特异性也较好(84.1%)。肺癌患者NSE、CYFRA21-1、PDGF-BB和D-D水平与临床分期呈正相关[相关系数(r)分别为0.318、0.527、0.776、0.683,P均<0.05],随着临床分期的增加而升高,Ⅲ/Ⅳ期明显高于I/II期(P<0.05)。结论联合检测NSE、CYFRA21-1、PDGF-BB和D-D对肺癌的诊断、鉴别诊断、病情监测及临床分期方面具有较重要的临床价值。
Objective To investigate the clinical significance of the combined determination of neuron specific enolase（NSE）, cytokeratin 19 fragment （ CYFRA21-1 ）, platelet-derived growth factor- BB （PDGF-BB） and D-dimer （D-D） for lung cancer patients. Methods The levels of serum NSE and CYFRA21-1 were detected by electrochemiluminescence immunoassay in 69 lung cancer patients, 48 patients with benign lung diseases and 65 healthy subjects. The levels of serum PDGF-BB were detected by enzyme-linked immunosorbent assay（ELISA）. The levels of plasma D-D were detected by immuno-nephelometry. The relationship of NSE, CYFRA21-1, PDGF-BB and D-D levels with the clinical stages of lung cancer was analyzed by statistics. Results The levels of NSE, CYFRA21-1, PDGF-BB and D-D in patients with lung cancer were significantly higher than those in patients with benign lung diseases and in healthy controls （ P 〈 0.01 ）. The patients with squamous cell carcinoma had the highest level of CYFRA21-1, and the patients with small cell lung cancer had the highest level of NSE. Compared with the other lung cancer groups, there was statistical significance （ P 〈 0.05 ）. The sensitivity sequence of the single parameter in the diagnosis of lung cancer was ： NSE 〉 CYFRA21-1 〉 PDGF-BB 〉 D-D. CYFRA21-1 showed the highest sensitivity （72.4%） in squamous cell carcinoma, and NSE showed the highest sensitivity （66.7%） in small cell lung cancer. The combined determination of NSE, CYFRA21-1, PDGF-BB and D-D might significantly improve the sensitivity and accuracy for the diagnosis of lung cancer. The combination of NSE, CYFRA21-1, PDGF-BB and D-D showed the highest sensitivity （89.9%）, the highest accuracy（86.3% ） and good specificity （84.1%） for the diagnosis of lung cancer. NSE, CYFRA2I-1, PDGF- BB and D-D were positively related to the clinical stages of lung cancer. With the increasing of clinical stages, the levels in m / 1v stage were significantly higher than those in I / H stage [ correlation
出处
《检验医学》
CAS
北大核心
2011年第11期741-745,共5页
Laboratory Medicine
