目的：探讨癌胚抗原（CEA）、细胞角蛋白19片段（CYFRA21-1）、神经元特异性烯醇化酶（NSE）联合检测在肺癌诊断中的临床价值。方法采用化学发光法对61例肺癌患者和38例肺部良性病变患者血清CEA、CYFRA21-1、NSE水平进行检测。根据接受者工作特性曲线（ROC），确定最佳截断点及诊断灵敏度、特异度。结果肺癌组患者血清CEA、CYFRA21-1、NSE水平均明显高于肺部良性病变组，差异有统计学意义（P＜0．05）；3项肿瘤标志物在不同病理类型肺癌中的水平差异无统计学意义（P＞0．05）；CEA诊断肺癌最佳截断点为3．50 ng/mL ，灵敏度和特异度分别为52．5％、94．7％；CYFRA21-1最佳截断点为5．21 ng/mL ，灵敏度和特异度分别为67．2％、93．1％；NSE最佳截断点为18．09 ng/mL ，灵敏度和特异度分别为77．0％、52．6％。3项指标联合检测的灵敏度为96．7％，高于3项单独检测时的灵敏度（P＜0．05）。结论检测CEA、CYFRA21-1和NSE对肺癌的诊断有一定价值，3者联合检测有明显的互补性，可提高肺癌诊断的灵敏度。%Objective To study the clinical significance of Carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (CY-FRA21-1) ,neuron specific enolization enzyme (NSE) combined detection in the diagnosis of lung cancer .Methods Using the Chemiluminescence to detect the level of CEA ,NSE and CYFRA21-1 in 61 patient with lung cancer (lung cancer group) and 38 pa-tients with benign diseases(control group) .All datas were analyzed with t test .Optimal cut-off point and diagnostic sensitivity ,spe-cificity were obtained by receiver operating characteristic curve (ROC) .Results The level of serum CEA ,NSE and CYFRA21-1 in Lung cancer group was significantly higher than that in control group (P<0 .05) .The expression level of three tumor markers was no statistically significant difference in the different pathological types of lung cancer (P>0 .05) .The cut-off point of CEA was 3 .50 ng/mL ,sensitivity and speciality were 52 .5% ,94 .7% respectively .The cut-off point of CYFRA21-1 was 5 .21 ng/mL ,the sensitiv-ity and specificity were 67 .2% ,93 .1% .The cut-off of point NSE was 18 .09 ng/mL ,the sensitivity and specificity were 77 .0% , 52 .6% .The three combined detection sensitivity was 96 .7% ,significantly higher than separate one(P<0 .05) .Conclusion The three tumor markers(CEA ,CYFRA21-1 ,NSE) might be valuable in the diagnosis of lung cancer .The combined detection could be used as a better pattern for screening lung cancer .
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