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目的:探讨肺癌患者血清肿瘤标记物细胞角蛋白19片段(CYFRA21-1)与肿瘤病理类型和吸烟的相关性和对肺癌的诊断价值。方法:应用化学发光技术测定经病理确诊的187例肺癌患者、33例肺良性疾病和健康对照的CYFRA21-1水平。应用SPSS18统计软件包分析病理类型、吸烟和CYFRA21-1间的关系。结果:187例肺癌患者血清中CYFRA21-1水平明显高于非良性病和健康对照组,肺良性病与健康对照组比无显著差别;187例患者吸烟者123例(65.7%),不吸烟者64例(34.2%)。在肺鳞癌、肺腺癌及小细胞肺癌中,吸烟者分别为72.9%、52.3%和73.0%,各组间行卡方分析χ2=8.03 P=0.018;血清CYFRA21-1在鳞癌、腺癌和小细胞肺癌的水平分别为13.96±22.84、7.12±12.22、3.66±4.66,各组间有显著差别(F=5.58,P=0.004);阳性率分别为58.8%、38.5%和32.4%,χ2=9.82,P=0.007,但腺癌与小细胞癌比无显著差别。cfyra211阳性率在非吸烟组、轻、中、重度吸烟组分别为39.1%、61.5%、52.2%和43.0%,四组间阳性率有显著差别,以非吸烟组为最低,重度吸烟组次之(χ2=9.542 P=0.023)。结论:cfyra211在肺鳞癌、腺癌和小细胞癌中肺鳞癌的水平和阳性率最高;肺鳞癌和小细胞癌吸烟者占大多数,cfyra211水平与吸烟无明显的相关性,但对肺鳞癌的诊断有一定的价值。
Objective: To investigate the correlation between serum cytokeratin 19 (CYFRA21-1) and tumor pathological types and smoking in patients with lung cancer and its diagnostic value for lung cancer. Methods: Chemiluminescence was used to determine the serum levels of CYFRA21-1 in 187 patients with lung cancer and 33 patients with benign pulmonary disease and healthy controls. SPSS18 statistical package was used to analyze the relationship between pathological types, smoking and CYFRA21-1. Results: Serum levels of CYFRA21-1 in 187 patients with lung cancer were significantly higher than those in non-benign and healthy controls. There was no significant difference between benign and malignant lungs in 187 patients (123.7%), non-smokers 64 cases (34.2%). In lung squamous cell carcinoma, lung adenocarcinoma and small cell lung cancer, the smokers were 72.9%, 52.3% and 73.0% respectively. The chi square analysis χ2 = 8.03 P = 0.018. The serum CYFRA21-1 levels in squamous cell carcinoma, (F = 5.58, P = 0.004). The positive rates were 58.8%, 38.5% and 32.4%, respectively. The positive rates of the two groups were 13.96 ± 22.84, 7.12 ± 12.22 and 3.66 ± 4.66, χ2 = 9.82, P = 0.007, but no significant difference between adenocarcinoma and small cell carcinoma. The positive rates of cfyra211 in non-smoking group were 39.1%, 61.5%, 52.2% and 43.0% in mild, moderate and severe smoking groups respectively. The positive rates of cfyra211 were significantly different among the non-smoking groups and the second among the severe smoking groups (χ2 = 9.542 P = 0.023). CONCLUSIONS: Cfray211 has the highest level and positive rate of squamous cell carcinoma in lung squamous cell carcinoma, adenocarcinoma and small cell carcinoma, smokers in lung squamous cell carcinoma and small cell carcinoma account for the majority, cfyra211 has no obvious correlation with smoking, The diagnosis of squamous cell carcinoma has a certain value.