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目的:探讨多种血清肿瘤标志物(CY211、NSE、CEA、CA125、CA199、SCC)对不同病理类型和临床分期的肺癌(无Ⅳ期病例)诊断的临床应用价值。方法:采用化学发光法检测266例不同病理分型和临床分期的肺癌患者血清CY211、NSE、CEA、CA125、CA199和SCC水平。结果:鳞癌患者血清肿瘤标志物以SCC的阳性率最高,为53.4%,且Ⅱ期和Ⅲ期患者SCC阳性率均明显高于Ⅰ期(P<0.05);腺癌患者血清肿瘤标志物以CEA的阳性率最高,达41.0%,各期间无明显差别;鳞癌组CY211阳性率明显高于腺癌组(P<0.05);神经内分泌癌组NSE辅助诊断的价值不同于预期。肿瘤标志物组合检测灵敏度和准确度均比单项检测有大幅提高。结论:SCC+CEA+CA125+CA199联合检测可有效地提高肺癌诊断的灵敏度和准确度。对于临床病例的监测,医生可根据病人肺癌病理类型选择最佳组合。
Objective: To investigate the clinical value of multiple serum tumor markers (CY211, NSE, CEA, CA125, CA199 and SCC) in the diagnosis of lung cancer with different pathological types and clinical stage (without stage IV). Methods: The serum levels of CY211, NSE, CEA, CA125, CA199 and SCC in 266 patients with different pathological types and clinical stages of lung cancer were detected by chemiluminescence method. Results: The positive rate of SCC was highest in patients with squamous cell carcinoma (53.4%), and the positive rates of SCC in stage Ⅱ and Ⅲ were significantly higher than those in stage Ⅰ (P <0.05). The serum tumor markers in patients with adenocarcinoma The positive rate of CEA was the highest (41.0%), with no significant difference between the two groups. The positive rate of CY211 in squamous cell carcinoma was significantly higher than that in adenocarcinoma (P <0.05). The value of NSE in neuroendocrine carcinoma was different from the expected value. Tumor marker combination detection sensitivity and accuracy are significantly higher than the single test. Conclusion: The combined detection of SCC + CEA + CA125 + CA199 can effectively improve the sensitivity and accuracy of lung cancer diagnosis. For the monitoring of clinical cases, doctors can choose the best combination of pathological types of patients with lung cancer.