Clinical Diagnostic Value Of Serum CEA,NSE,CA125 And CYFRA21-1 In Peripheral Bronchogenic Lung Cancer

ObjectiveTo investigate the diagnostic values of four tumor markers including CEA,NSE,CA125 and CYFRA21-1 in peripheral bronchogenic lung cancer and their relationship with lung cancer staging.Method463 patients,who were hospitalized in TangDu Hospital from January 1,2015 to April 30,2018,and with peripheral pulmonary lesion(PPL)diagnosed by guided sheath-guided ultrasound bronchus(EBUS-GS),were selected and divided into lung cancer groups and benign lesion group.The expression levels of four lung tumor markers in serum of patients in the two groups were analyzed,and the relationship between different pathological types of lung cancer(squamous cell carcinoma,adenocarcinoma,small cell carcinoma)and four tumor markers was analyzed.Results1.303 patients are in the lung cancer group,including 214 cases of adenocarcinoma,49 cases of squamous cell carcinoma,15 cases of small cell carcinoma,17 cases of poorly differentiated carcinoma,5 cases of adenosquamous carcinoma,2 cases of large cell carcinoma,1 case of carcinoid;benign lesion group had 160 patients,including 106 patients with bacterial pneumonia,34 patients with tuberculosis,5 patients with fungal pneumonia,5 patients with inflammatory pseudotumor,4 patients with pulmonary abscess,4 patients with pulmonary cryptococcosis,1 patient with silicosis,1 patient with pulmonary sequestration.The levels of CEA,NSE,CA125 and CYFRA21-1 in serum are significantly higher in the patients of lung cancer group than those in the benign lesion group(P<0.05).2.The sensitivity,specificity and Youden index of single tumor markers and combination markers are analyzed in 303 lung cancer patients.The single tumor marker CYFRA21-1 have the highest diagnostic value in the lung cancer group,with a sensitivity of 57.1% and its Youden index was 0.415.The CEA+CYFRA21-1 combined tumor markers have the highest diagnostic value in lung cancer group,with a sensitivity of 73.6% and an Youden index of 0.542.The sensitivity of the combined markers of these four tumor markers was 88.4%,the specificity was 45.0%,and the Yoden index was 0.334.Multiple tumor markers can improve the sensitivity of peripheral bronchial lung cancer.3.The higher the levels of CEA,NSE,CA125 and CYFRA21-1 in serum,the higher the possibility of lung cancer occurrence.When the level of CEA in serum is higher than 5 times of normal level,the lung cancer group accounted for 91.9%(57/62),of which adenocarcinoma accounted for 75.8%(47/62);when NSE level in serum was more than 2 times of the critical value,all patients were lung cancer,and the main pathological type is small cells and adenocarcinoma.When CA125 level in serum is more than 5 times of the critical value,all patients are lung cancer,and the main pathology types are adenocarcinoma and squamous carcinoma.When the serum level of CYFRA21-1 is higher than 5 times of the critical value,the lung cancer group accounted for 92.3%,and the main pathological type is NSCLC.4.The ROC curve analysis show that the optimal cut-off values of CEA,NSE,CA125 and CYFRA21-1 in the diagnosis of lung cancer group and benign group are 3.265 ng/ml,10.38 ng/ml,45.05 U/ml and 2.395 ng/ml,respectively.The area under the corresponding curve is 0.7970,0.7108,0.5852,and 0.7659,respectively.5.In the lung cancer group,183 patients with NSCCL had TNM staging,which are divided into earl(I-II)group and late(III-IV)group.The positive rates of CEA and CA125 have statistically significance difference between the two groups(P<0.05),and NSE and CYFRA21-1 have no statistically significant difference between the two groups(P>0.05).The levels of CEA,CA125 and CYFRA21-1 in serum have statistically significance difference between the two groups(P<0.05),and the level of NSE in serum have no statistically significant difference between the two groups(P>0.05).Conclusion1.CEA,NSE,CA125,CYFRA21-1 in the peripheral bronchial lung cancer screening can be a important supplementary means,the higher the level of serum type around the greater the possibility of bronchial lung cancer,and provide reference value in judging the pathological types and staging.2.CYFRA21-1 has the highest value of peripheral bronchial lung cancer.Multiple tumor markers can improve the sensitivity of peripheral bronchial lung cancer.CEA + CYFRA21-1 have the best sensitivity,specific degrees.3.ROC curve analysis participants adjust tumor markers positive values define value can improve the sensitivity and specific degrees.