The Evaluation Of Related Tumor Markers In Lung Cancer Diagnosis And Therapy Efficacy

ObjectiveTo detect the levels of serum tumor markers,including cyfra21-1, CEA, CA125, NSE, SCC and pro-GRP.Evaluating the related tumor markers in lung cancer diagnosis and therapy efficacy.Methods1.A total of174patients with lung cancer,58patients with benign lung diseases and72healthy volunteers were determined the levels of six serum tumor markers.2.The lung cancer group consisted of60SCC,76ADK,6LCLC,and32SCLC patients.In142NSCLC patients,72patients in stage I,25in stage II,29in stage Ⅲ,and16in stage IV.In32SCLC patients,23patients with limited disease(LD),and9patients with e xtensive disease(ED).34follow-up patients serum was collected before and after operation or chemotherapy.All the groups were with normal renal function.3.The tumor markers were all determined by ROCHE MODULAR ANALYTICS E170and ARCHITECT i2000.All the data were analyzed by SPSS17.0Software,with logistic regression and ROC curves.To improve the sensitivity and specificity in diagnosis of lung cancer by combined determination of tumor markers.Results1.The levels of cyfra21-1,CEA,NSE,CA125,pro-GRP in cancer group were higher than in benign lung diseases and healthy group. This difference was not statistically significant in SCC.2.Comparison of the levels in different pathologic types Cyfra21-1,SCC in lung squamous cell carcinoma,CEA in lung adenocarcinoma,NSE and pro-GRP in SCLC were higher than in other pathologic types.CA125was highest in LCLC with no statistical significance.3.Comparison the positive rate in groups The highest positive rate of cyfra21-1,CEA,NSE,SCC,pro-GRP was detected in cancer group.4.Comparison of the positive rate in different pathologic types Pro-GRP with90.6%positive rate was the highest in SCLC. Cyfra21-1,SCC in lung squamous cell carcinoma,CEA in lung adenocarcinoma,NSEin LCLC were higher than in other pathologic types.CA125in different pathologic types was not statistically significant.5.Comparison of different stages Pro-GRP was significantly increased in ED comparing with LD.NSE,cyfra21-1, CA125,CEA was not statistically significant,however increasing in terminal cancer patients.6.Comparison of AUC,sensitivity and specificity in all the single and combined determinations with ROC curves in lung group.(The combination of tumor markes was short for the front two capitals.) CY_CE_PR and CY_CE_CA_PR were better than other combinations in AUC,sensitivity and specificity.7.Comparison of AUC,sensitivity and specificity in all the single and combined determinations with ROC curves in NSCLC,lung adenocarcinoma and squamous cell carcinoma.In NSCLC group,the AUC of CY_CE_CA and CY_CE_NS_CA were greater than0.9.There was no statistical significance between the two combinations.In squamous cell carcinoma, group, CY_CE_CA_SC and CY_CE_NS_CA_SC were not statistically significant,with AUC greater than0.925.In lung adenocarcinoma group, CY_CE_NS was the most significant combination with AUC of0.930,sensitivity of 84.2%, and specificity of88.9%。In SCLC, NS_PR_CY_CE with AUC1.00was the best of them all.8.Comparison of tumor marker levels in follow-up patients before and after therapy.In patients with operation and chemotherapy,after the third treatment cycle,cyfra21-1and NSE concentration was reduced,which was statistically significant.In patients only with chemotherapy,NSE and pro-GRP concentration was obviously reduced.Conclusionl.When lung cancer occurred,the serum cyfra21-1,CEA,NSE,CA125,and pro-GRP concentration was increased significantly.The increased levels of cyfra21-1or SCC may be useful to evaluate lung squamous cell carcinoma,and CEA may reflect lung adenocarcinoma,NSE or pro-GRP may reflect small cell lung cancer.2.Pro-GRP concentration can reflect the stage of SCLC,and CA125^CEA are related to the TNM stage of NSCLC.3.CY_CE_CA_PR for lung cancer, CY_CE_CA for NSCLC, CY_CE_CA_SC for squamous cell carcinoma,CY_CE_NS for adenocarcinoma and NS_PR_CY_CE for SCLC,are of the highest application value in different pathologic types,which could predict the histologic type of lung cancer.4..In patients with operation and chemotherapy,after the third chemotherapy cycle,cyfra21-1,NSE and pro-GRP concentration was reduced,which may be useful for evaluating therapy efficacy.