| Background and purposeLarge cell neuroendocrine lung carcinoma(LCNEC)was proposed by Travils et al on 1991.In 1999,it was classified as a subtype of large cell lung cancer into the WHO classification of lung cancer,which was classified as neuroendocrine carcinoma of lung by WHO in 2015.LCNEC is a rare primary malignant tumor in the lung,and its incidence is the second most common in all lung neuroendocrine carcinomas.LCNEC can be expressed by typical neuroendocrine tumor markers,such as chromaffin,synaptophysin,neuron-specific enolase,and so on.These markers play an important role in the diagnosis of lung LCNEC.Among all lung cancers,LCNEC accounts for 0.3% of the total lung cancer,and its incidence is relatively low,and there are few clinical studies on the cognition and tumor markers of the disease.In recent years,serum markers have been widely studied in other pathological types of lung cancer(squamous cell carcinoma,adenocarcinoma,small cell carcinoma,etc.)and play an important role in the diagnosis,curative effect and prognosis of lung cancer.Therefore,42 patients with LCNEC and 67 patients with benign pulmonary diseases were selected as the study subjects,and the diagnostic value of combined detection of three serum tumor markers,CEA,CYFRA21-1 and NSE,and immunohistochemistry,Cg A,Syn,CD56 and TTF-1were explored in LCNEC.Materials and methodsFrom January 2012 to January 2016,42 patients with LCNEC were selected as observation group and 67 patients with benign pulmonary diseases as control group.There were 32 males and 10 females in the observation group and 43 males in the control group.24 women,20 cases of pulmonary infection,8 cases of pulmonary tuberculosis,4 cases of tuberculous pleurisy,14 cases of emphysema,11 cases of bronchial asthma,10 cases of interstitial pneumonia.There were 15 cases of stage Ⅰ/ Ⅰand 27 cases of stage Ⅲ/ Ⅲ.The difference of sex and age between the two groups was not statistically significant(P > 0.05)and it was comparable.Fasting venous blood was collected from all the observation and control groups.The serum was centrifuged at room temperature for 30 min.Then,the serum was detected by electrochemiluminescence at-80 ℃and the kit of Elecsys 1010 and Roche was used.All operations were carried out in strict accordance with the instructions.Patients above the normal value were marked as positive and according to the German Roche standard.The normal values of the detection index is as follow: CEA(0~5 ng/ml),CYFRA21-1(0.1~3.3 ng/ml),NSE(0~25 ng/ml).Statistical processingThe data were analyzed by SPSS 21.0 software.The quantitative data were expressed as mean ±standard deviation,the comparison between groups was expressed by t or Mann-Whitney U test,and the qualitative data was expressed by rate.There was statistical significance in comparison between groups using χ 2 test(P < 0.05).Result1.The results of the general data analysis are as follows: There were 42 cases of LCNEC in the observation group,including 32 males and 10 females,and 67 cases in the control group,including 43 males,24 females,20 pulmonary infections,8 pulmonary tuberculosis,4 tuberculous pleurisy,14 emphysema and 11 bronchial asthma.10 cases of interstitial pneumonia.The disease staging of patients with LCNEC was according to the 8th TNM staging standard of the International Association for Lung Cancer Research,including 15 cases of stage Ⅰ/ Ⅰand 27 cases of stage / Ⅲ Ⅲ.The sex and age of patients in the observation group and the control group were compared.The difference was not statistically significant(P > 0.05)and comparable.2.The Comparison of serum levels of CYFRA21-1 and NSE between the observation group and the control group shows that: The serum levels of CYFRA21-1 and NSE in the observation group were lower than those in the control group,The levels of CYFRA21-1 and NSE in the experimental group were 33.96 ±106.51 ng / ml,6.70 ±12.80 ng / ml and 46.38 ±53.14 ng / ml respectively,the control group was: 2.17 ±1.68 ng / ml 2.88 ±3.38 ng / ml and 12.6 ±9.42 ng / ml,which were significantly higher than those in the control group(P < 0.05).3.Analysis of sensitivity,specificity and accuracy shows that: the sensitivity of the three items combined with CYRA21-1 NSE CEA was the highest(73.8%).The highest specificity was 91.0%(3 items)combined with CYRA21-1 、NSE and CEA(51.0%).4.Comparison of the levels of three tumor markers in patients with different clinical stages of LCNEC:(1)The the levels of three tumor markers in patients with different clinical stages of LCNEC the serum levels of CEA and CYRRA21-1 in patients with stage Ⅰ/ Ⅰand stage Ⅲ/ Ⅲshows that,there was no significant difference(P > 0.05);(2)The level of serum NSE in patients with stage / was Ⅲ Ⅲhigher than that in patients with stage Ⅰ/Ⅱ(P < 0.05). Conclusion1.The sensitivity and specificity of LCNEC can be improved by detecting three Results tumor markers such as CEA,CYRA21-1 and NSE as compared with the detection of any one or two tumor markers in three CEA,CYRA21-1 and NSE serum tumor markers.2.The serum tumor marker level of NSE can provide a reference for clinical stage of LCNEC to some degree. |
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