The Value Of Combined Detection Of Serum CEA, CA125 And CA199 In Lung Cancer Diagnosis

Objective:The detection of serum tumor markerhas has been widely used in the diagnosis of lung cancer, but there was non tumor marker which has both sensitivity and specificity for lung cancer. The single detection of tumor marker existes certain limitations, so the lung cancer tumor markers combined detection becomes the research focus in recent years. The aim of this study was to investigate the prognostic value of serum tumor markers CEA, CA125 and CA199 in combination, and to provide a quick and simple method for early diagnosis of lung cancer.Materials and methods:1 SampleA total of 338 patients were collected from departments of respiratory medicine, oncology and surgical, Xingtai People’s Hospital from November 2013 to December 2014, including 236 lung cancer cases and 102 cases with benign lung disease. All patients with lung cancer were confirmed histopathologically. 50 outpatients of health physical examination were chosen as healthy control. When choosing the research object, make the distribution of age, sex and smoking roughly the same in three teams as far as possible. Serum tumor markers CEA, CA125 and CA199 were detected for all observation objects.2 Tumor markers determinationCA125 and CA199 were detected by CLEIA, while CEA by RIA.3 Statistical analysisThe SPSS17.0 software was used for statistical analysis. Methods of representation and examination were based on the distribution of quantitative data. Qualitative data was analyzed by nonparametric test of x2 test. Correlation analysis used the Spearman correlation analysis. ROC curve was used to evaluate the clinical value of these three tumor markers. α=0.05 was the level of text.Results:1 Mean levels of serum tumor markers in three groupsSerum CEA, CA125 and CA199 levels of lung cancer group were significantly higher than that of benign lung disease group and healthy group, the difference was statistically significant(P<0.05). Serum CA125 level of benign lung disease group was higher than healthy group, the difference was statistically significant(P<0.05).2 Mean levels of serum tumor markers in different pathological typesSerum CEA level of adenocarcinoma group was significantly higher than squamous cell carcinoma group and SCLC group, the difference was statistically significant(P<0.01), the difference between adenocarcinoma group and SCLC group wasn’t statistically significant(P>0.05). Serum CA125 levels of adenocarcinoma group and squamous carcinoma group were significantly higher than SCLC group, the difference was statistically significant(P<0.01), the difference between adenocarcinoma group and squamous carcinoma group wasn’t statistically significant(P>0.05). Serum CA199 level of adenocarcinoma group was higher than SCLC group; the difference was statistically significant(P<0.05).3 Mean levels of serum tumor markers in different stages and correlation analysisSerum CEA level of terminal stage was significantly higher than the early and middle stages, the difference was statistically significant(P<0.01), the difference between early and middle stage wasn’t statistically significant(P>0.05). Serum CA125 and CA199 levels of middle and terminal stages were significantly higher than that of early stage, the difference was statistically significant(P<0.01), the difference between middle and terminal stage wasn’t statistically significant(P>0.05).The Spearman correlation analysis results: CEA(r=0.342,P<0.01), CA125(r=0.217,P=0.217), CA199(r=0.251,P<0.01). The CEA was positively associated with lung cancer staging, and had the highest correlation coefficient; while the CA199 take the second place.4 The sensitivity and specificity of serum tumor markers(compared to benign lung disease group)Compared with CEA and CA199, CA125 had the highest sensitivity and the lowest specificity for lung cancer diagnosis, the difference was statistically significant(P<0.05). The sensitivity of combined detection of serum CEA, CA125 and CA199 was higher than any individual, the difference was statistically significant(P<0.05).5 Combined with ROC curve to evaluate the diagnostic value of these three tumor markers in lung cancer(compared to benign lung disease group)The AUC of CEA, CA125 and CA199 were all greater than 0.6, among which the CEA was the largest. The cut-off of CEA, CA125 and CA199 were respectively 16.36, 34.85 and 18.80, while the sensitivity and specificity were respectively 49.25%,64.93%,55.22% and 94.12%,63.73%,76.47%。6 Sensitivity of serum tumor markers in different stagesThe sensitivity of CEA: terminal stage> middle stage> early stage, the difference was statistically significant(P<0.05). The sensitivity of CA199 in early stage was lower than middle and terminal stages, the difference was statistically significant(P<0.05), while the difference between middle and terminal stags wasn’t statistically significant(P>0.05). Combined detection of serum CEA, CA125 and CA199 could effectively improve the sensitivity for lung cancer diagnosis, and the sensitivity were 54.84%, 77.50% and 81.34% respectively in early, middle and terminal stages.Conclusions:1 CEA, CA125 and CA199 could be used for distinguishing lung cancer and benign lung disease.2 The CEA could be used as clinical diagnosis index of lung adenocarcinoma, while the CA125 could be used for lung adenocarcinoma and squamous cell carcinoma diagnosis. None of these three tumor makers were fit for the diagnosis of SCLC.3 The CEA, CA125 and CA199 were positively correlated with lung cancer stages, and the CEA had the highest correlation coefficient. The higher the level of serum TM, the more serious the illness.4 Single tumor markers had low sensitivity for the diagnosis of lung cancer, combined detection could improve the sensitivity effectively for lung cancer diagnosis, however, the specificity decreased accordingly.5 Using ROC could improve the value of combined detection of CEA, CA125 and CA199 in lung cancer diagnosis. The cut-off of CEA, CA125 and CA199 were respectively 16.36, 34.85 and 18.80.6 The rise of serum tumor marker was not very obvious in early stage, and the sensitivity was lower. Combined detection of CEA, CA125 and CA199 could effectively increase the detection rate of early lung cancer.