CAJ | 학술논문

测定了239例肺癌病人(其中腺癌129例，鳞癌59例，小细胞癌35例，腺、鳞癌混合型癌16例)和66例其它肺疾患病人胸水和血清中骨胶素 (CYFRA21-1)、癌胚抗原(CEA)、烯醇化酶(NSE)的浓度。结果显示三项测定的总阳性率依次是CYFRE21-1为51.4%，CEA 43.5%，NSE 48.1%，但与病理类型相关，鳞癌以CY FRA21-1最高为76.3%，腺癌以CEA最高达57.1%，而小细胞肺癌则以NSE最高达94.3%。49例伴有胸水患者(腺癌27例、小细胞肺癌7例、其它良性肺疾患15例)的胸水和血清三项测定结果显示腺癌病人的胸水样本CYFRA21-1和CEA测定均较血清样本更灵敏，而小细胞肺癌病人胸水样本的NSE测定具有极可靠的价值。比较三项测定对不同病理类型癌症病人的敏感性和特异性在非癌症的其它肺疾病患者中的假阳性和假阴性，并进一步讨论三项联合测定的临床意义和必要性。
측정료239례폐암병인(기중선암129례，린암59례，소세포암35례，선、린암혼합형암16례)화66례기타폐질환병인흉수화혈청중골효소 (CYFRA21-1)、암배항원(CEA)、희순화매(NSE)적농도。결과현시삼항측정적총양성솔의차시CYFRE21-1위51.4%，CEA 43.5%，NSE 48.1%，단여병리류형상관，린암이CY FRA21-1최고위76.3%，선암이CEA최고체57.1%，이소세포폐암칙이NSE최고체94.3%。49례반유흉수환자(선암27례、소세포폐암7례、기타량성폐질환15례)적흉수화혈청삼 항측정결과현시선암병인적흉수양본CYFRA21-1화CEA측정균교혈청양본경령민，이소세포폐암병인흉수양본적NSE측정구유겁가고적개치。비교삼항측정대불동병리류형암 증병인적민감성화특이성재비암증적기타폐질병환자중적가양성화가음성，병진일보토론삼항연합측정적림상의의화필요성。
hree tumor markers or CEA, CYFRA21-1 and NSE were assayed in 239 cases with lung cancer (adenocarcinoma 129, squamous-cel l carcinoma 59, small cell lung cancer 35, mixed type of adenocarcinoma and squamous-cell carcinoma 16) and 66 cases with benign lung disease. The p ositive rate of CEA, CYFRA21-1 and NSE for detecting lung cancer were 51.4%, 43.5% and 48.1% respectively. It seemed there was a relationship betwee n the sensitivity and the pathologic patterns of lung cancer. The highest diagnostic sensitivities were 76.3% for CYFRA21-1 in the detection of squa mous-cell carcinoma, 57.4% for CEA in adenocarcinoma and 94.3% for NSE in the small cell lung cancer respectively. In 49 cases with pleural effusion (adenocarcinoma 27, small cell lung cancer 7, benign disease 15), three tumor markers in serum and pleural fluid were both measued. The results ind icated that the sensitivity of the CEA and CYFRA21-1 in pleural fluid in patients with adenocarcinoma was superior to serum. The detection of the NS E in pleural fluid was a very reliable method in diagnosing the small cell lung cancer. The sensitivity and specificity of CEA， CYFRA21-1 and NSE i n different pathologic patterns of lung cancer was compared and also the false positive and false negative in benign lung disease. Moreover, the cli nical role and necessity of combined determination were also discussed.