摘要目的:研究血清微小RNA-21(miRNA-21)与肿瘤标志物[癌胚抗原(CEA)、细胞角蛋白(CYFRA21-1)、神经元特异性烯醇化酶(NSE)]对早期非小细胞肺癌的诊断价值。方法:从2018年1月至2019年3月大庆龙南医院所收治的恶性肿瘤患者中选取22例非小细胞肺癌患者为研究组，再选择相同时间段内在该院进行健康体检的22例为对照组。对两组对象进行相应检查，对血清miRNA-21、主要肿瘤标志物的水平、以及病理类型与标志物水平的关系进行分析。结果:研究组血清miRNA-21(2.15±0.9)、CEA(34.1±4.9)ng/mL、NSE(27.1±2.2)ng/mL、CYFRA21-1(12.1±1.2)ng/mL，均高于对照组( t＝6.524、27.392、23.339、27.685，均 P＝0.000)；腺癌患者血清微小RNA-21(1.88±1.14)、CEA(30.1±19.9)ng/mL、细胞角蛋白(12.8±5.2)ng/mL，均低于鳞癌患者，NSE[(26.1±3.2)ng/mL]水平高于鳞癌患者，差异均有统计学意义( t＝1.158、1.192、0.423、1.913， P＝0.260、0.247、0.677、0.070)；Ⅲ～Ⅳ期非小细胞肺癌患者血清miRNA-21(2.58±0.96)、CEA(38.1±17.9)ng/mL、CYFRA21-1(16.8±6.2)ng/mL、NSE(26.9±10.2)ng/mL，均高于Ⅰ～Ⅱ期非小细胞肺癌患者，但仅CYFRA21-1差异有统计学意义( P<0.05)，其它三项差异无统计学意义( t＝1.478、0.574、2.114、1.015， P＝0.155、0.573、0.047、0.322)。 结论:非小细胞肺癌患者接受血清miRNA-21与肿瘤标志物CEA、CYFRA21-1、NSE的联合检查，诊断准确率较高，这对于患者的诊治与预后评估等十分关键，可作为非小细胞肺癌患者的首选诊断方式。

abstractsObjective:To study the diagnostic value of serum microRNA21 and tumor markers CEA, CYFRA21-1 and NSE in early non-small cell lung cancer (NSCLC).Methods:From January 2018 to March 2019, 22 patients with NSCLC in Daqing Longnan Hospital were selected as the study group, and 22 people who underwent health examination in our hospital during the same period were selected as the control group.The levels of serum microRNA21, major tumor markers and the relationship between pathological types and markers were observed and analyzed.Results:The serum levels of miRNA-21 (2.15±0.9), CEA [(34.1±4.9)ng/mL], NSE [(27.1±2.2)ng/mL], and CYFRA21-1 [(12.1±1.2)ng/mL] in the study group were higher than those in the control group( t=6.524, 27.392, 23.339, 27.685, all P=0.000). The serum levels of miRNA-21 (1.88±1.14), CEA [(30.1±19.9)ng/mL], CYFRA21-1 [(12.8±5.2)ng/mL] in adenocarcinoma patients were lower than those in patients with squamous cell carcinoma, and the level of NSE [(26.1±3.2)ng/mL] was higher than that of patients with squamous cell carcinomas ( t=1.158, 1.192, 0.423, 1.913, P=0.260, 0.247, 0.677, 0.070). The serum levels of miRNA-21 (2.58±0.96), CEA [(38.1±17.9)ng/mL], CYFRA21-1 [(16.8±6.2)ng/mL], NSE [(26.9±10.2)ng/mL] in NSCLC patients with Ⅲ~Ⅳ stage were higher than those in NSCLC patients with Ⅰ-Ⅱ stage, but only CYFRA21-1 had statistically significant difference( P<0.05), there were no statistically significant differences in the other three indicators ( t=1.478, 0.574, 2.114, 1.015, P=0.155, 0.573, 0.047, 0.322). Conclusion:The combined examination of serum microRNA-21 and tumor markers CEA, CYFRA21-1 and NSE in patients with NSCLC can effectively confirm the diagnosis, which is very important for the diagnosis, treatment and prognosis of patients.This diagnosis can be the first choice for patients with NSCLC.