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目的：评价血清癌胚抗原(carcinoembryonic antigen，CEA)和细胞角蛋白19 的片段(CYFRA21-1)水平对原发性肺癌的诊断价值。方法：回顾性分析2012年5 月～2013 年5 月我科收治的329 例肺癌患者和192 例肺部良性病变患者的临床资料。结果：肺癌患者血清CEA 或CYFRA21-1 水平随着肺癌的分期呈现逐渐上升的趋势（P<0.001，P<0.01）。以血清CEA≥ 3.4 滋g/L 作为诊断条件诊断肺癌的灵敏度、特异度和阳性预计值预计值分别为67%、62%和75.2%；以血清CYFRA-21≥ 5.0 ug/L作为诊断条件诊断原发性肺癌的灵敏度、特异度和阳性预计值预计值分别为48%、87%和86.3%；以血清CEA≥ 3.4 ug/L 和CYFRA-21≥ 5.0 ug/L 共同作为诊断条件推断原发性肺癌的灵敏度、特异度和阳性预计值预计值分别为48%、87%和86.3%；良性肺部疾病患者中血清CEA 和CYFRA-21 水平同时升高者只有2%。结论：血清CEA≥ 3.4 ug/L 和CYFRA-21≥ 5.0 ug/L 同时升高对肺癌有具有重要的诊断价值，可有效的鉴别原发性肺癌与其它良性病变。

英文摘要:

Objective:Assess diagnostic value of CEA and CYFRA21-1 in primary lung cancer.Methods:A retrospective analysis was conducted on 329 patients treated for lung cancer and 192 patients treated for benign lung disease between May 2012 and May 2013.Results:The serum levels of CEA and CYFRA21-1 showed a tendency to be increased in the more advanced stages of lung cancer. Sensitivity, specificity and positive predictive values of CEA in the diagnosis of primary lung cancer was 67%, 62% and 75.2 % using 3.2 ug/L as the cut-off level, respectively. Sensitivity, specificity and positive predictive values of CYFRA21-1 in the diagnosis of primary lung cancer was 48%, 87%and 86.3%using 5.0 ug/L as the cut-off level, respectively. Sensitivity, specificity and positive predictive values with the combination of positive CEA and positive CYFRA 21-1 in the diagnosis of primary lung cancer was 13%, 98% and 91.3% using the cut-off level, respectively. The combination of positive CEA and positive CYFRA21-1 at the cut-off level in the benign disease was only 2%.Conclusion:Combining CEA and CYFRA 21-1 are reliable serum tumor markers for the diagnosis of lung cancer, if the prevalent rate of patients is high, are helpful to distinguish primary lung cancer frombenign lung disease.

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