Clinical Value Of Tumor Markers In The Diagnosis And Curative Effect Evaluation Of Advanced Lung Cancer

Objective :Serum tumor markers(tumor, marker, TM) is one of the major research topics of modern oncology. has great practical value in lung cancer screening, diagnosis, curative effect evaluation; the poor sensitivity of single markers and specificity, there are some limitations in the diagnosis of lung cancer. Therefore, this paper discusses the combined detection of serum carcinoembryonic antigen(CEA), cytokeratin 19 fragment(CYFRA21-1), neuron specific enolase(NSE), carbohydrate antigen 125(CA125) 72-4(CA72-4) and glycoprotein antigens in the evaluation of advanced lung cancer diagnosis and treatment of adenocarcinoma, squamous cell carcinoma in clinical application value.Methods: 1. According to the condition of entering the group and exclusion criteria were selected, 126 cases of patients with advanced lung cancer from 2013.1 to 2014.8 for the first time in the Department of respiration of First Hospital Affiliated to Suzhou University diagnosed, 30 cases of pulmonary infection patients as the control group, the observation of tumor markers in the diagnosis of reference value. 2. Chemotherapy for squamous cell carcinoma of docetaxel plus platinum chemotherapy, adenocarcinoma of pemetrexed plus platinum. Observation of squamous cell carcinoma, adenocarcinoma in 2 cycles and 4 cycles of chemotherapy changed tumor marker levels and chest CT target lesion size, in order to analyze and evaluate the diagnosis and treatment of tumor marker, to judge whether in lung cancer have a certain diagnostic value.Results: 1. Comparison of tumor markers in different pathological types of lung cancer positive rate: the sensitivity of CYFRA21-1 and NSE were higher in lung squamous cell carcinoma and small cell lung cancer(72.7% and 71.7%), The sensitivity of CA125, CYFRA21-1, CEA in lung adenocarcinoma were higher(respectively 72.4%, 62.1%, 56.9%). 2. The level of tumor markers in different pathological types of lung cancer: CEA is highest in adenocarcinoma, NSE is highest in small cell lung cancer. CYFRA21-1 were significantly higher in squamous cell carcinoma and adenocarcinoma, the differences were statistically significant. Therefore, CEA increased suggesting that adenocarcinoma, CYFRA21-1 increased suggesting that squamous cell carcinoma or adenocarcinoma. NSE increased suggesting that small cell lung cancer. It has important clinical value of CEA+ CYFRA21-1 combined detection in the diagnosis of pulmonary adenocarcinoma. CA125 and CA72-4 extremely elevated suggesting that adenocarcinoma. With mild-to-moderate increased can be appearanced in pulmonary infection and various pathological types, Therefore, CA125 and CA72-4 examination in the diagnosis of lung cancer and pathological classification of clinical significance is not big. 3. The reference value of NSE in small cell lung cancer staging: NSE was significant higher in extensive stage than the limited stage, the difference was statistically significant(p<0.05). 4. The comparative tracking index of patients before and after chemotherapy:(1) The effect of chemotherapy of squamous cell carcinoma was poor, In the process of chemotherapy, target lesions have only gradually narrowing trend(<10%), but of no statistical significance. further studies found that the correlation analysis of the relative changes of CYFRA21-1 and tumor associated with no obvious.(2) 25 cases of adenocarcinoma(adenocarcinoma A CEA negative group) CEA level in the course of treatment has fluctuated in normal range and low level, Our study found that the effect of chemotherapy in patients with CEA negative patients was poor, correlation analysis showed significantly positive correlation with the relative changes of CYFRA21-1 and CT tumor size(Pearson coefficient 0.44, p=0.002). The relative change of CA125 and the tumor size had no significant correlation(Pearson coefficient 0.22, p=0.118), but there is still a high value of CA125 cases, tumor size with the level of CA125 was significantly decreased.(3) 9 cases of CEA in the course of treatment has been more than 100, of which 4 cases of partial remission(adenocarcinoma B group), 5 cases of tumor increased significantly(adenocarcinoma C group), In view of the CEA normal low level and detection limit of 100, thus unable to evaluate the effect of CEA on the curative effect of these patients. At the same time that CEA continued high, prompt treatment ineffective or need dynamic observation of CEA to evaluate the efficacy of treatment.(4) 24 cases in the treatment of patients with reduced CEA(adenocarcinoma group D), tumors were relieved in different degrees, the statistical analysis showed that the tumor was significantly reduced after chemotherapy, accompanied by tumor markers decreased, the differences were statistically significant.Conclusions: 1. CEA has an important reference value for the diagnosis of adenocarcinoma. It has important reference value of NSE in diagnosis of small cell lung cancer, CYFRA21-1 in squamous cell carcinoma and adenocarcinoma. The combined detection of CEA and CYFRA21-1 also elevated suggesting adenocarcinoma, with CA125 and CA72-4 increased further suggesting adenocarcinoma. 2. NSE is helpful in clinical staging of small cell lung cancer. 3. For CEA negative and high advanced adenocarcinoma patients, Pemetrexed combined with platinum chemotherapy effect is poor, may not be the best choice. CEA, CFRA21-1, CA125 dynamic levels contribute to chemotherapy in adenocarcinoma and the curative effect evaluation, and improve the prognosis.