| Objective To investigate the clinical values of five tumor markers(NSE,CEA,CA125,CYFRA21-1and Pro-GRP)and the single and combined detection of micro RNA145 and micro RNA25 in the diagnosis of small cell lung cancer.Methods75 cases of lung cancer from March 2017 to February 2018 in Guangzhou Red Cross Hospital,the First Affiliated Hospital of Jinan University and the First Affiliated Hospital of Guangzhou Medical University were selected,including 21 cases of small cell lung cancer,32 cases of lung adenocarcinoma and 22 cases of lung squamous cell carcinoma.In addition,42 normal subjects were selected as normal controls,36 patients with chronic obstructive pulmonary disease,pneumonia and other pulmonary infections as controls.The contents of NSE,CEA,CA125,CYFRA21-1,Pro-GRP and miR-145 and miR-25 in blood of each subject were quantitatively detected,and the difference between tumor markers and micro RNA in each group was compared.The ROC curve was used to analyze the sensitivity,specificity and accuracy of single or joint detection of tumor markers with significant differences.Results1.Concentrations of five lung cancer tumor markers NSE,CEA,CA125,CYFRA21-1,and Pro-GRP in the lung cancer group were 34.18±10.24 ng/ml,29.23±8.45 ng/ml,52.13±21.11U/ml,and 9.66,respectively.±4.53 ng/ml and 91.26±35.01 pg/ml;concentrations in the normal control group were 14.71±0.92 ng/ml,2.72±0.26 ng/ml,35.20±10.98 U/ml,2.24±0.14 ng/ml,and 29.12,respectively ±16.2 pg/ml;the corresponding values in benign lesions were 15.28±2.70 ng/ml,3.38±0.35 ng/ml,37.98±18.77 U/ml,3.39±0.43 ng/ml,and28.65±26.85 pg/ml,respectively;The levels of NSE,CEA,CA125,CYFRA21-1,and ProGRP in the group were significantly higher than those in the normal control group and the benign lung disease group.The difference was statistically significant;there was no significant difference between the normal control group and the benign lung disease group.2.The normal control group and the benign disease group were combined as a case control group.The concentrations of NSE,CEA,CA125,CYFRA21-1and Pro-GRP for the five lung cancer tumor markers were 15.09±1.24 ng/ml?3.07±0.21 ng/ml?36.09±8.01U/ml?2.75±0.22 ng/ml and 29.64±22.12 pg/ml.3.In SCLC,,the concentrations of NSE,CEA,CA125,CYFRA21-1,and Pro-GRP were49.43±8.00 ng/ml,4.26±2.4 ng/ml,39.71±3.47 U/ml,and 6.65±0.63 ng/ml and 645.8±242.4 pg/ml,compared with the case control group,the concentrations of NSE,CYFRA21-1,and Pro GRP were significantly higher,and the difference was statistically significant.4.In pulmonary adenocarcinoma,the concentrations of NSE,CEA,CA125,CYFRA21-1,and Pro-GRP were 20.04±4.73 ng/ml,46.59±21.77 ng/ml,109.52±41.24 U/ml,and 9.56±4.24 ng,and 39.46±3.62 pg/ml,compared with the case control group,the concentrations of CEA,CA125,CYFRA21-1 and Pro-GRP were significantly increased,and the difference was statistically significant.5.In lung squamous cell carcinoma,the concentrations of NSE,CEA,CA125,CYFRA21-1and Pro-GRP were 15.80±1.54 ng/ml,7.48±2.3 ng/ml,43.17±13.30 U/ml,13.59±3.86 ng/ml and 39.86±4.29 pg/ml,compared with the case control group,the concentration of CYFRA21-1and CEA increased significantly,the difference was statistically significant.6.ROC curves were further analyzed for tumor markers with significant differences.In the small cell lung cancer,the area under the ROC curves of NSE,Pro-GRP and CYFRA21-1were 0.936,0.972 and 0.852,respectively.Compared with CYFRA21-1,the difference between NSE and Pro GRP was statistically significant.The sensitivity of NSE,Pro-GRP and CYFRA21-1 in the diagnosis of small cell lung cancer were 0.7,0.76 and 0.43 respectively;the specificities were 0.75,0.84 and 0.46;the accuracy was 0.62,0.77 and 0.49;NSE and Pro-GRP,respectively;The sensitivity,specificity,and accuracy of combined detection in the diagnosis of small cell lung cancer were 0.91,0.75,and 0.83,respectively.Compared with single detection,the combined detection of NES and Pro-GRP has higher sensitivity in the diagnosis of small cell lung cancer.And accuracy.7.In lung adenocarcinoma,the area under the ROC curves of tumor markers CEA,Pro-GRP,CYFRA21-1,and CA125 were 0.973,0.946,0.922,and 0.855,CEA,CYFRA21-1,and Pro GRP,respectively,and the differences were statistically significant compared to CA125.Meaning.The sensitivity of single detection of CEA,CA125,CYFRA21-1 and Pro-GRP in the diagnosis of lung adenocarcinoma were 0.67,0.78,0..56 and 0.38,respectively;the specificities were 0.69,0.57,0.52 and 0.65,respectively;The sensitivity,specificity,and accuracy of the joint detection of CA125 and CEA were 0.81,0.79,and 0.83,respectively.Compared with the single detection and other combinations,the combined detection was higher in the diagnosis of lung adenocarcinoma.Diagnostic efficiency.8.In lung squamous cell carcinoma,the area under the tumor markers CYFRA21-1 and CEA ROC were 0.952 and 0.934,respectively.CYFRA21-1 had statistically significant differences with CEA.CYFRA21-1and CEA were diagnosed in squamous cell carcinoma of the lung.Sensitivity was 0.75 and 0.71 respectively;specificity was 0.81 and 0.57;accuracy was 0.87 and 0.51 respectively;sensitivity,specificity and accuracy of CYFRA21-1 and CEA combined detection were 0.80,0.78 and 0.93,respectively.Detection has better diagnostic efficacy in the diagnosis of squamous cell carcinoma of the lung.9.The relative expression levels of miR-145 in small cell lung cancer group,non-small cell lung cancer group and normal control group were 0.96±0.24,1.73±1.12 and 0.86±0.63,respectively.The difference in miR-145 between the non-small cell group and the normal control group was statistically significant.The area under the miR-145 curve in the diagnosis of non-small cell lung cancer was 0.704,the sensitivity was 71.2%,and the specificity was59.5%.10.The relative expression levels of miR-25 in the small cell lung cancer group,non-small cell lung cancer group and normal control group were 1.03±0.67,1.09±0.53,and 1.28±0.91,respectively.There was no statistically significant difference in miR-25 among the three groupsConclusion The joint detection of five tumor markers can achieve better results than the single detection of tumor markers in the diagnosis of lung cancer.Among them,the combined detection of NSE and Pro-GRP in the diagnosis of small cell lung cancer,CA125 and CEA combined detection of lung adenocarcinoma and CYFRA21-1 and CEA combined detection of squamous cell carcinoma of the lung cancer sensitivity,specificity and accuracy have reached High levels;micro RNA-145 is also effective in the diagnosis of non-small cell lung cancer.The application of micro RNA-25 in the diagnosis of lung cancer still has a lot of research space. |
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