The Value Of Tumor Markers In TNM Staging Of Non-Small Cell Lung Cancer

Objective:To research the levels of tumor markers(CYFRA21-1,CEA,CA125 and CA199)in different TNM stages of NSCLC,analysis the value of CYFRA21-1,CEA,CA125 and CA199 in the staging of non-small cell lung cancer.Methods:We retrospectively analyzed the clinical data of patients with non-small cell lung cancer diagnosed by pathology or immunohistochemistry without any anti-tumor treatment who visited Jiangxi provincial people’s hospital for the first time from September 2015 to January 2019.According to the TNM staging method of the eighth edition of the international union against cancer(UICC),patients were divided into four groups according to stage I-IV,At the same time,it was divided into adenocarcinoma group and squamous cell carcinoma group according to pathological types.Record the levels of tumor markers(CYFRA21-1,CEA,CA125 and CA199)in each group,and made a statistical analysis of the difference between adenocarcinoma and squamous cell carcinoma.The chi-square test was used to compare the positive rates,the median(quartile)was used to represent the measurement data,the Mann-Whitney U test was used to compare the differences between the two groups,the Kruskal-Wallis H test was used to analyze the differences between the groups,and the ROC curve was used to evaluate the diagnostic effect.The test level was 0.05,in other words,P-value less than 0.05 indicates statistical significance.Results:1.CYFRA21-1,CEA and CA125 expression levels and positive rates increased significantly with the increase of lung adenocarcinoma stages,The expression levels of CYFRA21-1,CEA and CA125 in patients with stage Ⅲ-Ⅳlung adenocarcinoma were higher than those in patients with stage Ⅰ-Ⅱ lung adenocarcinoma,and the differences were statistically significant(P<0.05).However,there was no significant difference in the expression level and positive rate of CA199 between different stagesof lung adenocarcinoma(all P were >0.05).2.CYFRA21-1 and CA125 expression levels and positive rates increased significantly with the increase of lung squamous cell carcinoma stages,The expression levels of CYFRA21-1 and CA125 in patients with stage Ⅲ-Ⅳlung squamous cell carcinoma were higher than those in patients with stage Ⅰ-Ⅱ lung squamous cell carcinoma,and the differences were statistically significant(P<0.05).While the expression levels and positive rates of CEA and CA199 were not statistically significant at different stages of lung squamous cell carcinoma(all P were >0.05).3.The AUC of CYFRA21-1,CEA and CA125 in the stage Ⅲ-Ⅳlung adenocarcinoma patients were 0.828,0.858 and 0.804,and their best cut-off value were 4.425ng/ml,7.91ng/ml,and 19.54U/ml.The AUC of CYFRA21-1 and CA125 in the stage Ⅲ-Ⅳlung squamous cell carcinoma patients were 0.826 and 0.741,and their best cut-off value were 6.245ng/ml and 35.845U/ml.Conclusion:1.CYFRA21-1,CEA and CA125 can act as a reference factor in the TNM staging of lung adenocarcinoma.and their best cut-off value for the diagnosis of stage Ⅲ-Ⅳlung adenocarcinoma were 4.425ng/ml,7.91ng/ml and 19.54U/ml.2.CYFRA21-1 and CA125 can act as a reference factor in the TNM staging of lung squamous cell carcinoma.and their best cut-off value for the diagnosis of stage Ⅲ-Ⅳlung squamous cell carcinoma were 6.245ng/ml and 35.845U/ml.