目的 探究血清细胞角蛋白19片段(CYFRA21-1)、癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、人源性阳离子抗菌肽18(hCAP18)及组织多肽特异性抗原(TPS)在肺癌诊断中的价值.方法 选取肺癌患者52例(肺癌组),肺部良性疾病患者45例(良性疾病组),健康体检者40例(正常组),测定比较三组血清CYFRA21-1、NSE、CEA、hCAP18及TPS水平及阳性检出率,评估各肿瘤标志物及联合检测的诊断效能.结果 肺癌组血清CYFRA21-1、NSE、CEA、hCAP18及TPS水平明显高于良性疾病组及正常组(P＜0.05).肺癌组CYFRA21-1、NSE、CEA、hCAP18、TPS及五项联合阳性检出率为61.54％、51.92％、55.77％、67.31％、75.00％及98.08％,明显高于良性疾病组的8.89％、11.11％、6.67％、11.11％、11.11％及13.33％和正常组的2.50％、2.50％、5.00％、5.00％、7.50％及7.50％ (P＜0.05).五项肿瘤标志物联合检测灵敏度为96.15％,准确度为92.70％,明显高于各单项检测(P＜0.05).结论 血清CYFRA21-1、NSE、CEA、hCAP18及TPS联合检测诊断肺癌可减少漏诊的发生,提高准确度.%Objective To investigate the diagnostic value of serum cytokeratin 19 fragment (CYFRA21-1),carcinoembryonic antigen (CEA),neuron specific enolase (NSE),human cationic antimicrobial peptide 18 (hCAP18),and tissue polypeptide specific antigen (TPS) in lung cancer.Methods 52 patients with lung cancer were selected as lung cancer group,45 patients with benign lung disease as benign lung disease group,40 healthy individuals as normal group.The levels and positive detection rates of serum CYFRA21-1,NSE,CEA,hCAP18,TPS in three groups were deteeted and compared.Evaluated the diagnostic efficacy of each and combination detection of tumor markers.Results The levels of serum CYFRA21-1,NSE,CEA,hCAP18,TPS in lung cancer group were significantly higher than those in benign lung disease group and normal group (P＜0.05).The positive detection rates of serum CYFRA21-1,NSE,CEA,hCAP 18,TPS,and combination test in lung cancer group were 61.54％,51.92％,55.77％,67.31％,75.00％,98.08％,which were higher than 8.89％,11.11％,6.67％,11.11％,11.11％,13.33％ in benign lung disease group and 2.50％,2.50％,5.00％,5.00％,7.50％,7.50％ in normal group (P＜0.05).The sensitivity and accuracy of combination detection of five tumor biomarkers were 96.15％ and 92.70％,which were higher than those of single tumor biomarker detection (P＜0.05).Conclusion The combination detection of serum CYFRA21-1,NSE,CEA,hCAP18,and TPS can reduce missed diagnosis and improve accuracy in the diagnosis of lung cancer.
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