中文摘要：

目的评价6种血清肿瘤标志物联合检测对肺癌诊断和治疗的临床意义。方法选择2014年1月至10月在安徽省济民肿瘤医院住院治疗的肺癌患者206例，其中经病理或细胞学证实的初治肺癌患者110例，鳞癌37例，腺癌30例，小细胞肺癌（SCLC）30例，鳞腺癌13例；同期选择60例健康体检者和61例良性肺部疾病患者（肺结核36例，一般肺内感染25例）作为对照。采用酶联免疫吸附试验（ELISA）检测各组血清神经元特异性烯醇化酶（NSE）、细胞角蛋白19片段（CYFRA21-1）、癌胚抗原（CEA）、组织多肽特异性抗原（TPA）、胃泌素释放肽前体（pro-GRP）、抑癌基因P53表达蛋白（P53抗体）水平，分析6种血清肿瘤标志物单项或联合应用对肺癌的临床诊断价值。结果肺癌组血清CEA、TPA、P53抗体、pro-GRP、CYFRA21-1、NSE水平均明显高于良性肺部疾病组和健康对照组，差异具有统计学意义（P均〈0．05）；而后两组间差异无统计学意义。进一步分析显示，P53抗体在腺癌、鳞癌、鳞腺癌、SCLC中的水平均较高，分别为（3．1±2-2）、（3．8±2．3）、（2．9±2．1）、（3．4±1．8）pg，L，且差异无统计学意义（P〉0．05）；CEA在腺癌中高效表达，且明显高于鳞癌、鳞腺癌、SCLC（μg／L：10．3±7,4比8．4±4．9、8．8±4．8、8．5±5．1，P均〈0．05）；NSE和pro-GRP在SCLC中表达量较高，且明显高于腺癌、鳞癌、鳞腺癌[NSE（μg／L）：36．7±22．2比14．7±7．2、16．5±14．3、13．6±5．9，pro-GRP（μg/L）：58．2±55．4比7．9±7．1、7．7±4．8、9．2±6．8，P均〈0．01]；TPA、CYFRA21-1在鳞癌中高效表达，且表达量明显高于腺癌、鳞腺癌和SCLC[TPA（μg/L）：7．9±6．7比5．8±4．6、5．1±4．2、4．1±3．3，CYFRA21-1（μg/L）：11．2±4．5比7．8±5．4、7．3±5_3、7．4±4．8，P均〈0．05]。6种血清肿瘤标志物联合检测用于诊断肺?

英文摘要：

To analyze the clinical effect of six kinds of serum tumor markers and their combined power for the diagnosis and treatment of lung cancer. Methods 206 patients with lung cancer admitted to Anhui Jimin Cancer Hospital from January to October in 2014 were enrolled, and 110 patients with primary lung cancer were confirmed by pathology or cytology, squamous cell carcinoma in 37 patients, adenocarcinoma in 30 patients, small cell lung carcinoma （SCLC） in 30 patients, adeno-squamous carcinoma in 13 patients. Over the same period, 60 healthy subjects and 61 patients with benign pulmonary disease （36 patients of pulmonary tuberculosis, 25 patients of general pulmonary infection） were selected as the control group. The levels of six serum tumor markers including neuronspecific enolase （NSE）, cell keratin 19 fragment （CYFRA21-1）, carcinoembryonic antigen （CEA）, tissue polypeptide specific antigen （TPA）, pro-gastrin-releasing peptide（pro-GRP）, and tumor suppressor gene P53 expression protein （P53 antibody） were detected by enzyme linked immunosorbent assay （ELISA）. Clinical diagnosis accuracy of lung cancer by the six kinds of serum tumor markers alone or combined were analyzed. Results The levels of serum CEA, TPA, P53 antibody, pro-GRP, CYFRA21-1, and NSE in lung cancer patients were significantly higher than those of healthy adults and patients with respiratory infection with statistical differences （P all 〈 0.05）, but no significant difference was found between the later two groups. Further analysis showed that P53 antibody in adenocarcinoma, squamous cell carcinoma, adeno-squamous carcinoma, and SCLC was in the higher level, which was （3.1 ± 2.2）, （3.8 ±2.3）, （2.9 ±2.1）, （3.4 ± 1.8） μg/L respectively, without statistical differences （P 〉 0.05）. CEA in adenocarcinoma with high expression, which was significantly higher than that in squamous cell carcinoma, adeno-squamous carcinoma, and SCLC （μg/L： 10.3 ± 7.4 vs. 8.4 ± 4.9, 8.8 ± 4.8, 8.5 ± 5.