标题：肺癌患者胸腔积液Cyfra21-1、NSE的测定及临床意义

      作者：陆媛 1，邹江浩 1，李江博 1，赵琳 1，何雨峰 2    1.西安市第一医院检验科，陕西 西安 710002；2.西安医学院第二附属医院检验科，陕西 西安 710038

      卷次： 2019年30卷10期

      【摘要】 目的 探讨肺癌患者胸腔积液细胞角蛋白19片段(Cyfra21-1)及神经元特异性烯醇化酶(NSE)的测定及临床意义，以期为肺癌的诊治提供临床依据。方法 选择2016年1月至2018年6月期间在西安市第一医院住院治疗的62例肺癌胸腔积液患者(肺癌组)及50例良性胸腔积液患者(良性组)为研究对象，其中肺癌患者包括非小细胞肺癌(NSCLC) 42例，小细胞肺癌(SCLC) 20例；病理分期为Ⅰ~Ⅱ期27例，Ⅲ~Ⅳ期35例，采用电化学发光法测定两组患者的胸腔积液Cyfra21-1、NSE水平。结果 肺癌组患者胸腔积液中的Cyfra21-1、NSE水平分别为(27.09±8.12) ng/mL和 (23.39±7.02) ng/mL，明显高于良性组的 (2.25±0.74) ng/mL和 (5.04±2.77) ng/mL，阳性率分别为53.23%和 54.84%，明显高于良性组的 2.00%和 4.00%，差异均有统计学意义(P<0.05)；NSCLC组患者的胸腔积液Cyfra21-1水平及阳性率分别为(31.80±12.18) ng/mL、66.67%，均高于SCLC组的(8.23±3.84) ng/mL、25.00%，SCLC组患者的胸腔积液NSE水平及阳性率分别为(32.51±10.42) ng/mL、70.00%，均高于NSCLC组的(20.85±6.27) ng/mL、47.62%，差异均有统计学意义(P<0.05)；病理分期为Ⅲ~Ⅳ期的肺癌患者，其胸腔积液Cyfra21-1和NSE分别为(40.91±13.37) ng/mL、(38.46±16.29) ng/mL，明显高于 I~Ⅱ期肺癌患者的(26.34±8.25) ng/mL和(17.82±4.34) ng/mL，差异均有统计学意义(P<0.05)。结论 胸腔积液Cyfra21-1和NSE测定对肺癌的诊断及病理分期判断具有较大的应用价值。
      【关键词】 肺癌；胸腔积液；肿瘤标志物；细胞角蛋白19片段；神经元特异性烯醇化酶
      【中图分类号】 R734.2 【文献标识码】 A 【文章编号】 1003—6350（2019）10—1283—03

Determination of neuron specific enolase and cytokeratin 19 fragment in pleural effusion of patients with lungcancer and its clinical significance.
LU Yuan 1, ZOU Jiang-hao 1, LI Jiang-bo 1, ZHAO Lin 1, HE Yu-feng 2. 1.Department of Clinical Laboratory, Xi'an First Hospital, Xi'an 710002, Shaanxi, CHINA; 2. Department of ClinicalLaboratory, the Second Affiliated Hospital of Xi'an Medical University, Xi'an 710038, Shaanxi, CHINA
【Abstract】 Objective To investigate the clinical significance of cytokeratin 19 fragment (Cyfra21-1) and neu-ron specific enolase (NSE) in the pleural effusion of lung cancer patients and to provide clinical basis for the diagnosisand treatment of lung cancer. Methods Sixty-two patients with pleural effusion in lung cancer (lung cancer group), in-cluding 42 patients of non-small cell lung cancer (NSCLC) and 20 patients of small cell lung cancer (SCLC), and 50 pa-tients with benign pleural effusion (benign gruop) were selected in Xi'an First Hospital from January 2016 to June 2018.There were 27 cases of stageⅠ toⅡ and 35 cases of stageⅢ toⅣ in pathological stages. The levels of Cyfra21-1 andNSE in pleural effusion were measured by electrochemiluminescence. Results Cyfra 21-1 and NSE in pleural effusionof lung cancer group were (27.09 ± 8.12) ng/mL and (23.39 ± 7.02) ng/mL, respectively, and the positive rates were53.23% and 54.84% respectively, which were significantly higher than (2.25 ± 0.74) ng/mL and (5.04 ± 2.77) ng/mL,2.00% and 4.00% in benign group (P<0.05). The levels and positive rates of Cyfra21-1 in pleural effusion in NSCLCgroup were (31.80±12.18) ng/mL and 66.67%, respectively, significantly higher than (8.23±3.84) ng/mL and 25.00% inSCLC group (P<0.05). The levels and positive rates of NSE in pleural effusion in SCLC group were (32.51±10.42) ng/mL and70.00%, respectively, significantly higher than (20.85±6.27) ng/mL and 47.62% in NSCLC group (P<0.05). Cyfra21-1and NSE in pleural effusion of lung cancer patients with pathological stage Ⅲ to Ⅳ were (40.91 ± 13.37) ng/mL and(38.46±16.29) ng/mL, respectively, which were significantly higher than (26.34±8.25) ng/mL and (17.82±4.34) ng/mL of