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目的了解肺泡冲洗液中肿瘤标志物癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)和神经元希醇化酶(NSE)联合检测在肺癌诊断中的应用价值。方法应用电化学发光技术测定56例肺癌患者、83例肺部良性疾病患者和30例正常对照者肺泡冲洗液以及血清中的CEA、CYFRA21-1、NSE水平。结果肺癌组肺泡冲洗液中的CEA、CYFRA21-1和NSE水平均高于肺良性疾病组和对照组,其中CEA和CYFRA21-1水平与肺良性疾病组差别有统计学意义(P<0.05),而NSE差别无统计学意义(P>0.05)。CEA、CYFRA21-1和NSE对肺癌诊断的阳性率分别为62.50%,64.28%,53.57%,而三者联合检测对肺癌的诊断阳性率为94.64%,单项与联合检测的阳性率差别有统计学意义(P<0.05)。在肺癌患者组中肺泡冲洗液的单项阳性率和联合检测的阳性率均较血清组高,但差别均无统计学意义(P>0.05)。结论联合检测肺泡冲洗液CEA、CYFRA21-1和NSE3种肿瘤标志物,对肺癌的诊断具有较高的敏感度和临床应用价值。
Objective To investigate the value of combined detection of CEA, CYFRA21-1 and NSE in the diagnosis of lung cancer. Methods The levels of CEA, CYFRA21-1 and NSE in alveolar lavage fluid and serum of 56 patients with lung cancer, 83 patients with benign pulmonary disease and 30 normal controls were determined by electrochemiluminescence. Results The levels of CEA, CYFRA21-1 and NSE in alveolar fluid in lung cancer group were significantly higher than those in benign lung disease group and control group. The difference between CEA and CYFRA21-1 levels and benign lung disease group was statistically significant (P <0.05) The NSE difference was not statistically significant (P> 0.05). The positive rates of CEA, CYFRA21-1 and NSE in diagnosing lung cancer were 62.50%, 64.28% and 53.57%, respectively. The positive rate of combined detection of CEA, CYFRA21-1 and NSE in lung cancer was 94.64%. The positive rates of single and combined detection were statistically different Significance (P <0.05). In lung cancer patients, the single positive rate of alveolar fluid and the positive rate of combined detection were higher than those in serum group, but the difference was not statistically significant (P> 0.05). Conclusions Combined detection of CEA, CYFRA21-1 and NSE tumor markers in alveolar washing fluid has high sensitivity and clinical value in the diagnosis of lung cancer.