| Objective:To evaluate the clinical application value of serum tumor molecular markers carbohydrate antigen CA50(carbohydrate antigen,CA50),carcinoembryonic antigen(carcino embryonic antigen,CEA)CEA,squamous cell carcinoma antigen(squamous cell carcinoma antigen,Scc-Ag)Scc-Ag and cytokeratin 19 fragment antigen 21-1(cytokeratin19 fragments antigen21-1,CYFRA21-1)CYFRA21-1,multi-effect protein(PTN pleiotrophin,PTN)and neuron specific enolization enzyme(neuron-specific enolase,NSE)NSE joint dynamic testing in the diagnosis,treatment and monitoring of early lung cancer.Methods: 201 cases of lung cancer before and after treatment,50 patients with lung benign lesions and 50 cases of healthy physical examination were selected as the research object respectively.The electrochemical luminescence method and enzyme-linked immune method were used to detect the serum tumor molecular marker levels of CA50,CEA,Scc Ag,CYFRA21-1,PTN and NSE.Serum tumor molecular marker CA50,CEA,Scc Ag,CYFRA21-1,PTN and NSE expression levels of three groups were statistically analyzed.The correlation of different lung cancer clinical pathologic factors of patients(patients' gender,age,tumor location,tumor diameter,the proliferation of cancer metastasis and clinical stage,pathological histology,recurrence,with pleural effusion,and after treatment)with serum levels of tumor molecular markers were evaluated.The diagnosis value in lung cancer(the differences of sensitivity,accuracy,specificity,positive predictive value,negative predictive value,positive likelihood ratio and negative quasi likelihood ratio)of single and joint detection of the serum tumor molecular marker were compared.Result:(1)CA50,CEA,Scc Ag,CYFRA21-1,PTN,NSE expression levels in the serum of patients with lung cancer were significantly higher than those in lung benign disease group and normal control group(P < 0.01).Serum CA50,CEA,Scc-Ag,CYFRA21-1,PTN,NSE expression level positive was no significant difference in control group and normal control group(P > 0.05).(2)CA50,CEA,Scc Ag,CYFRA21-1,PTN,NSE serum levels of lung cancer patients had no significant correlation with patients' gender,age and tumor location(P > 0.05),but had obvious relevance with tumor diameter,the proliferation of cancer metastasis and clinical stage,pathological histology,recurrence,pleural effusion,and the treatment.The correlation of CA50,CEA,Scc-Ag,CYFRA21-1,PTN,NSE serum levels with tumor size,clinical stage,metastasis,pleural effusion,treatment was statistically significantly(P<0.01).(3)Serum CA50 and CEA of lung adenocarcinoma patients had high expression level and high detection rate.Serum Scc-Ag and CYFRA21-1 of lung squamous carcinoma patients had high expression level and high detection rate.Serum PTN and NSE of small cell lung cancer patients had high expression level and high detection rate.The positive rate of CA50 combined with CEA,Scc Ag combined with CYFRA21-1,PTN combined with NSE in the detection of lung adenocarcinoma,squamous cell carcinoma and small cell carcinoma(CEA)was significantly higher than that of each single test(all P<0.01).(4)The sensitivity of CA50,CEA,Scc-Ag,CYFRA21-1,PTN and NSE in the diagnosis of lung cancer was 46.27(93/201),49.75(100/201),50.75(102/201),44.28(89/201),50.25(101/201),48.76(98/201)respectively,accuracy was 55.38(139/251)?57.77(145/251)?59.36(149/251)?53.39(134/251)?58.57(147/251)?56.97(143/251)respectively.The specificity 86%(43/50)of six serum tumor molecular markers CA50,CEA,Scc-Ag,CYFRA21-1,PTN and NSE joint detection in diagnosis of lung cancer was reduced,but the sensitivity 95.02%(191/201)and accuracy 93.23%(234/251)significantly increased,which had statistical significance compared with the single examination(all P<0.01).Conclusion:The combined detection of serum tumor markers CA50,CEA,Scc-Ag,CYFRA21-1,PTN,NSE can be used as an effective method for early screening of lung cancer,which is conducive to early detection and treatment of clinical follow-up,and dynamic detection can monitor the curative effect and prognosis. |
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