为研究外周血中肿瘤标志物癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、细胞角质蛋白19片段(CYFRA21-1)、糖链抗原125(CA125)、鳞状上皮细胞癌抗原(SCC)检测在肺部孤立性结节鉴别诊断中的价值,选取上海市胸科医院2013年9月至2015年1月295例因肺部孤立性结节入院患者的血清标本,其中恶性结节患者221例,良性结节患者74例,采用化学发光法检测患者血清中SCC的表达水平,采用流式荧光法检测血清中CEA、NSE、CA125和CYFRA21-1的表达水平,评价现有肿瘤标志物在良、恶性肺部孤立性结节鉴别诊断中的价值。结果显示,良性和恶性肺部孤立性结节患者血清中CA125和SCC的浓度无明显差异,没有统计学意义(P>0.05);而恶性结节患者血清中CEA,NSE和CYFRA21-1的检测水平显著高于肺部良性结节患者,差异有统计学意义(P<0.05)。在肺部孤立性结节实验室鉴别诊断中,CEA的灵敏度为59.7%,特异度为81.1%;NSE的灵敏度为36.7%,特异度为85.1%;CYFRA21-1的灵敏度为50.2%,特异度为70.3%;三者联合检测灵敏度达60.2%,特异度达85.1%。以上结果说明,NSE、CYFRA21-1和NSE的联合检测在肺部孤立性结节鉴别诊断中具有一定的临床价值。 In order to study tumor markers such as CEA, NSE, CYFRA21-1, CA125, squamous cell carcinoma Antigen (SCC) in the diagnosis of solitary pulmonary nodules in the differential diagnosis of selected Shanghai Thoracic Hospital from September 2013 to January 2015 295 cases of patients with isolated solitary pulmonary nodules in serum samples, including malignant 221 cases of nodules and 74 cases of benign nodules. The expression of SCC in serum was detected by chemiluminescence. The expression of CEA, NSE, CA125 and CYFRA21-1 in serum was detected by flow cytometry, The Value of Tumor Markers in Differential Diagnosis of Solitary and Nodular Solitary Pulmonary Nodules. The results showed that serum CA125 and SCC concentrations in benign and malignant solitary pulmonary nodules had no significant difference (P> 0.05), while the serum levels of CEA, NSE and CYFRA21-1 in patients with malignant nodules The level was significantly higher than that of benign pulmonary nodules, the difference was statistically significant (P <0.05). The sensitivity of CEA was 59.7% and the specificity was 81.1% in the differential diagnosis of solitary pulmonary nodules in the lung. The sensitivity and specificity of CEA were 36.7% and 85.1%, respectively. The sensitivity of CYFRA21-1 was 50.2% 70.3%. The combined detection sensitivity of the three was 60.2% and the specificity was 85.1%. The above results indicate that the combined detection of NSE, CYFRA21-1 and NSE has certain clinical value in the differential diagnosis of solitary pulmonary nodules.