CAJ | 학술논문

联合检测神经元特异烯醇化酶(NSE)、细胞角蛋白19片段(CYFRA21-1)、D-二聚体(D-D)、Fib(纤维蛋白原)，探讨其在肺癌患者中的临床意义。方法肺癌组(256例)、肺良性疾病组(200例)和正常对照组(200例)的血清NSE、CYFRA21-1水平采用电化学发光分析法检测，血浆D-二聚体、Fib水平采用免疫比浊分析法检测，对肺癌患者NSE、CYFRA21-1、D-二聚体、Fib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、D-二聚体、Fib水平与肺良性病与正常对照组相比，差异具有统计学意义(P<0.01)。小细胞肺癌(SCLC)中NSE的水平最高，CYFRA21-1在非小细胞肺癌组(NSCLC)中的肺鳞癌中的水平最高，与其他肺癌组比较，差异均具有统计学意义(P<0.05)。单项参数在肺癌初诊中的敏感性为NSE>CYFRA21-1>D-二聚体>Fib。小细胞肺癌中NSE的敏感度最高(68.4%)，肺鳞癌中CYFRA21-1的敏感性最高(69.0%)。NSE、CYFRA21-1、D-二聚体、Fibrinogen联合检测可以明显提高肺癌诊断的敏感性(89.8%)。肺癌患者NSE、CYFRA21-1、D-二聚体、Fib水平与临床分期也呈正相关(相关系数(r)分别为0.615，0.425，0.669，0.523，P<0.05)，且随着临床分期的增加而升高，Ⅲ/Ⅳ明显高于Ⅰ/Ⅱ期(P<0.05)。结论 NSE、CYFRA21-1、D-二聚体、Fib的联合检测对肺癌的诊断、鉴别诊断、病情监测等方面具有重要的临床价值。
연합검측신경원특이희순화매(NSE)、세포각단백19편단(CYFRA21-1)、D-이취체(D-D)、Fib(섬유단백원)，탐토기재폐암환자중적림상의의。방법폐암조(256례)、폐량성질병조(200례)화정상대조조(200례)적혈청NSE、CYFRA21-1수평채용전화학발광분석법검측，혈장D-이취체、Fib수평채용면역비탁분석법검측，대폐암환자NSE、CYFRA21-1、D-이취체、Fib수평여림상분기관계진행통계학분석。결과폐암조혈청NSE、CYFRA21-1、D-이취체、Fib수평여폐량성병여정상대조조상비，차이구유통계학의의(P<0.01)。소세포폐암(SCLC)중NSE적수평최고，CYFRA21-1재비소세포폐암조(NSCLC)중적폐린암중적수평최고，여기타폐암조비교，차이균구유통계학의의(P<0.05)。단항삼수재폐암초진중적민감성위NSE>CYFRA21-1>D-이취체>Fib。소세포폐암중NSE적민감도최고(68.4%)，폐린암중CYFRA21-1적민감성최고(69.0%)。NSE、CYFRA21-1、D-이취체、Fibrinogen연합검측가이명현제고폐암진단적민감성(89.8%)。폐암환자NSE、CYFRA21-1、D-이취체、Fib수평여림상분기야정정상관(상관계수(r)분별위0.615，0.425，0.669，0.523，P<0.05)，차수착림상분기적증가이승고，Ⅲ/Ⅳ명현고우Ⅰ/Ⅱ기(P<0.05)。결론 NSE、CYFRA21-1、D-이취체、Fib적연합검측대폐암적진단、감별진단、병정감측등방면구유중요적림상개치。
Objective To discuss the clinical significance of the combined determination of NSE,CYFRA21-1, D-Dimer, Fibrinogen for lung cancer patients. Methods The levels of serum NSE and CYFRA21-1 were detected by electrochemical analysis in 256 lung cancer patients, 200 patients with benign lung diseases and 200 health subjects. The levels of plasma D-Dimer and Fibrinogen were detected by immunoturbidimetric assays. The relationship of NSE, CYFRA21-1, D-Dimer and Fibrinogen levels with the clinical stages of lung cancer was analyzed by statistics. Results The levels of NSE, CYFRA21-1, D-Dimer and Fibrinogen in patients with lung cancer were significantly higher than those in patients with benign lung diseases and healthy controls(P<0.01).The patients with squamous cellcarcinoma had the highest level of CYFRA21-1,and the patients with smal celllung 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 > D-Dimer > Fibrinogen.CYFRA21-1 showed the highest sensitivity(69.0%) in squamous cellcarcinoma, and NSE showed the highest sensitivity(68.4%%) in smal celllung cancer. The combined determination of NSE, CYFRA21-1, D-Dimer, Fibrinogen might significantly improve the sensitivity for the diagnosis of lung cancer. The combined determination of NSE,CYFRA21-1, D-Dimer, Fibrinogen showed the highest sensitivity(89.8%).NSE,CYFRA21-1, D-Dimer, Fibrinogen were positively related to the clinical stages of lung cancer. With the increasing of clinical stages, the levels of NSE,CYFRA21-1, D-Dimer, Fibrinogen in Ⅲ/Ⅳ stage were significantly higher than those in Ⅰ/Ⅱ stage(correlation coefficie nt(r)=0.315,0.425,0.669,0.523,). Conclusions The combined determination of NSE, CYFRA21-1, D-Dimer, Fibrinogen has an important clinical significance in the clinical diagnosis, differentiation, monitor and clinical stage of lung cancer.