Clinical Significance In Lung Cancer With Kinds Of The Combined Determination Of Serum Tumor Markers In The Yan'an Area

[background]: The primary bronchial tube lung cancer (abbreviation lung cancer) is the common malignant tumor, its disease incidence rate and the mortality rate unceasingly rise, has become in the world scope one of cancer death main reasons, although lung cancer treatment had has been very greatly progressive in the past 20 years, after but the patient pregnosis actually not obviously enhanced, 5 years survival rate was only 15%. After the lung cancer pregnosis clinical closely is connected by stages with the diagnosis time: 0 issue of lung cancer patients technique latter 5 years survival rate may reach above 90%, I issue is 60%, II ~ IV issue of patient from 40% drop to 5% below. Appears in the patient which the symptom receives a medical examination 80% already is III, IV issue loses the surgery opportunity. Therefore, picks out the early lung cancer after to reduce the lung cancer the mortality rate and the improvement always pregnosis has the vital significance. At present the lung cancer diagnoses the multi- bases cytology inspection and the organization pathology inspection, although the specificity is higher, but the sensitivity is not high, but not drafts likely or X recessive lung cancer to the early time ferrets out with difficulty. The serology tumor marker (serum tumor marker, STM) after the tumor general survey, the diagnosis, judges pregnosis and the extension turns over to the aspect to have the bigger use value, is one of modern oncology research important topics. The lung cancer serology TM examination has become one of lung cancer diagnosis important targets, however, at present uses in to examine the lung cancer markers to be many for the tumor correlation matter, not yet discovers in view of the lung cancer specificity antigen. Moreover, sole lung cancer marker determination sensitivity, specificity unsatisfactory, has the certain limitation to the lung cancer diagnosis. The lung cancer markers combination examination is one of hot spots which at present studies. The different combination The different combination has different results,, at present still lacked the big sample to gather together the analysis(Mata). In addition, the Yan'an area is situated at the loess plateau, the climate, the soil and the diet custom has the regional specificity, the many kinds of serology tumor sign union examination diagnoses in the Yan'an area lung cancer patient the clinical significance to be worth studying.[Objective]: To the lung cancer patient cell Cytokeratin 19 antigen (Cytokeratin Fragment Antigen 21-1, CYFRA21-1), glycoprotein125 (Carbohydrate antigen125 CA125), the neuron specificity enolase (neuron-specific enolase, NSE), the cancer embryo antigen (carcinoembryonicantigen, CEA) carries on the union examination, appraises it to diagnose in the Yan'an area lung cancer patient the value and the clinical significance.[Method]: Stochastically selects 2007.3 ~ 2008.3 yan'an university affiliated hospital breath internal medicine department, the chest heart surgical department and the tumor branch is hospitalized the lung cancer case of illness 60 examples which the pathology diagnoses (to name as lung cancer group), TNM by stages I-IV issue, including: The cellule lung cancer (small cell lung cancer, SCLC) the group, the non- cellule lung cancer (non-small cell lung cancer, NSCLC) the group, the NSCLC component is the scale cancer, the gland cancer group; Same time the stochastic selection lung benign pathological change patient 35 examples (name as lung benign pathological change group, benign lung disease, BLD), including: The chronic blocking lung disease acute attack 7 examples, the pneumonia 8 examples, the lungs tuberculosis 10 examples, the asthma 3 examples, the bronchiectasis 1 example, the chronic lung source heart disease acute aggravates the time 6 examples. Passes through the clinical manifestation, the laboratory inspection, X sternum and/or the phlegm examines found the acid-proof bacillus to diagnose, after the sterilization, the anti- tuberculosis treatment changes for the better; The healthy crowd 35 examples (name as comparison group). Uses the The electrochemiluminescence immuno-assay ( ECLIA ) law examination blood serum CYFRA21-1, NSE, CEA, CA125. Each group of determinations value gender the examination with the variance analysis, the positive rate comparison examines with x2.[Results]:1. In NSCLC, SCLC, BLD and the health comparison group four item of TM masculine gender rate aspect, CA125 respectively is 70.1%, 45.7%, 13.0%, 6.06%; CYFRA21-1 respectively is 62.9%, 46.8%,11.2%, 0%; NSE respectively is 15.5%, 66.7%, 9.6%, 0%; CEA respectively is 58%,38.5%, 10%, 0%. 2. In lung cancer patients blood serum CEA, NSE, CA125, the CYFRA21-1 masculine gender rate remarkably is higher than the benign pulmonary tuberculosis group and the healthy group, the difference has statistics significance (P <0.05).3. In the diagnosis lung cancer specificity and the sensitive aspect, CA125 respectively is 77.1%, 51.7%; CYFRA21-1 respectively is 80.0%, 56.7%,; NSE respectively is 61.1%, 62.5%; CEA respectively is 58.2%, 69.0%.4. Lung cancer groups CA125, CYFRA21-1, NSE and CEA examination masculine gender rate and lung cancer pathology type related, CA125 masculine gender rate by NSCLC group highest (70.1.8%), CYFRA21-1 take scale cancer group as highest (78.7%), CEA by gland cancer group highest (69.7%), NSE group is highest by SC the LC (66.7%), they separately compare with other pathology types, the difference has has significant statistics significance (P<0.05).5. III, IV issue of lung cancer patient blood serum CA125, CYFRA21-1, NSE and the CEA masculine gender rate is higher than I, II (P<0.05).6. After the four kinds of tumors marker,CA125, CYFRA21-1, NSE and the CEA , combination ,the joint inspect positive rate are higher than the single item with three examinations masculine genders rate, four joint inspects may cause the early lung cancer the diagnosis rate enhancement to 96.5%. The blood serum tumor marker union examination has the higher clinical clinical reference value in the lung cancer diagnosis. The sensitivity obviously is higher than the free single item tumor marker.7.Passes through the chemotherapy or the surgery treats effective case of illness CA125, CYFRA21-1, NSE and the CEA 4 item of tumors marker comparatively treats drops (P<0.05).[Conclusion]:(一)the single item examination aspect:1. CA125, CYFRA21-1, NSE and the CEA 4 serology tumors marker express in the lung cancer patient high, the non- lung cancer group expresses relatively is lower; Is helpful to the lung benign disease and the lung cancer distinction, is helpful to the NSCLC assistance diagnosis.2.CA125,CYFRA21-1, NSE and CEA have the certain value to the lung cancer diagnosis, the CYFRA21-1 masculine gender rate by the lung scale cancer highest, CEA masculine gender rate by lung gland cancer highest, the NSE masculine gender rate is highest by SCLC. 4 kind of targets are helpful to the lung cancer pathology minute. 3.CYFRA21-1,NSE and the CEA single item examination sensitivity, the specificity homogeneous phase correlation are low.4. III, IV issue of lung cancer patient blood serum CA125, CYFRA21-1, NSE and the CEA masculine gender rate is higher than I, II (P<0.05).5. Pairs of chemotherapies and the surgery treat effective lung cancer case of illness CA125, CYFRA21-1, NSE and CEA comparatively treats the remarkable drop, prompts the above target to have the possibility to take one of determination different pathology type chemotherapy curative effect appraisal targets.(二)The Combined Determination r aspect:1. CA125, CYFRA21-1, NSE and the CEA combined determination is the valuable combination method, but remarkably enhances lung cancer picking out rate, is helpful to the lung cancer in particular early time lung cancer diagnosis, and can provide the powerful assistance diagnosis basis for the treatment.2. 4 kind of targets elevate in the non- cellule lung cancer later period, CEA, NSE, CA125, CYFRA21-1 have the higher assistance diagnosis value to the lung cancer, 4 signs combined determination may remarkably enhance the lung cancer diagnosis the sensitivity and the specificity.(三) the experimental aspect:The electrochemistry shines the law tumor marker determination is one kind of fast, easily, the sensitive lung cancer assistance diagnosis method.