Clinical Value Of The Levels Of Serum Pulmonary Tumor Markers And Ca²⁺ And ALP Detection In Diagnosing The Bone Metastasis Of Lung Cancer

Objective:Lung cancer is the leading cause of cancer-related deaths worldwide.Bone is the most common and earliest site of lung cancer metastasis.Bone metastases not only cause physical pain,including pain,fractures,and spinal compression,but they also cause mental distress,which significantly reduces quality of life and overall survival.Therefore,early diagnosis and active treatment of complications play an important role in improving the quality of life of patients.This study to investigate the clinical diagnostic value of pulmonary tumor marker carcinoembryonic antigen（CEA）,cytokeratin 19 soluble fragment（CYFRA21-1）,carbohydrate antigen 125（CA125）,serum calcium(Ca²⁺)and serum alkaline phosphatase（ALP）levels in bone metastasis of lung cancer.Methods:70 cases of primary lung cancer diagnosed by pathology in Hefei First People’s Hospital from September 2016 to March 2018 were selected as research objects.They were divided into bone metastasis group and boneless metastasis group.Diagnostic criteria for bone metastases:bone scan showed lesion metastasis,and was confirmed by CT or MRI as osteolytic bone metastasis or mixed bone metastasis.In patients with no bone metastases,bone scan did not confirm lesion metastasis within 1month.Exclusion criteria:A,endocrine diseases affecting bone metabolism（e.g.poorly controlled diabetes,thyroid and parathyroid function changes）;B,history of severe osteoporosis,rheumatic arthropathy,traumatic fracture;C,bisphosphonate,calcium,hormones were applied within 90 days before enrollment;D,radiotherapy was given 4weeksbeforeenrollment;E,pregnantorlactatingpatients;F,severe comorbidities.There were 32 cases in the bone metastasis group,including 18 males and14 females,aged from 28 to 80 years old.There were 38 cases in the group without bone metastasis,including 21 males and 17 females,aged 30-79 years.On the second day of admission,3 mL of venous blood was extracted on an empty stomach in the morning.Serum CEA,CYFRA21-1,CA125,Ca2+and ALP were detected in all patients by automatic electrochemiluminescence immunoassay and automatic biochemical analyzer,and the expression levels of each group were compared.Results:The levels of serum CEA,CYFRA21-1,CA125,Ca²⁺and ALP in bone metastasis group were（36.54±10.40）ng/ml,（27.01±8.15）ng/ml,（88.75±18.13）U/ml,（2.55±0.20）mmol/Land（113.25±43.57）U/L,respectively,which were significantly higher than（25.26±8.15）ng/ml,（21.57±6.92）ng/ml,（67.10±14.86）U/ml,（2.31±0.16）mmol/L and（74.13±36.21）U/L of the non-bone metastasis group,there was significant difference（P<0.01）.The levels of CEA,CA125 and Ca²⁺in multiple bone metastasis group（number of bone metastasis≥2）and single bone metastasis group were[（37.40±9.49）ng/ml vs（33.49±13.59）ng/ml],[（90.83±18.99）U/ml vs（81.35±13.19）U/ml]and[（2.54±0.21）mmol/L vs（2.60±0.11）mmol/L],respectively,which were significantly higher than（25.26±8.15）ng/ml,（67.10±14.86）U/ml and（2.31±0.16）mmol/L of the non-bone metastasis group there was significant difference（P<0.05）.The level of CYFRA21-1 in the multiple bone metastasis group was（28.47±7.60）ng/ml,which was significantly higher than[（21.78±8.45）ng/ml vs（21.57±6.92）ng/ml]of the single bone metastasis group and the boneless metastasis group,there was a significant difference（P<0.05）.The ALP of the multiple bone metastasis group was（118.08±44.75）U/L was significantly higher than（74.13±36.21）U/L of the boneless metastasis group,there was significant difference（P<0.01）.For the diagnosis of bone metastasis of lung cancer,the serum CYFRA21-1,sensitivity was up to 81.3%and the serum calcium specificity was up to 89.5%.The sensitivity and specificity of the 5 indexes were higher,respectively93.8%and 86.8%.Conclusion:The levels of serum pulmonary tumor markers and Ca2+and ALP were measured in combination,which has clinical diagnostic value for bone metastasis of lung cancer.