Clinical Values Of Combination Measurement Of Five Tumor Markers In Early Diagnosis Of Lung Cancer

Objective:Early pathogenesis of lung cancer is latent,the clinic lacks early diagnosis index,most patients have been diagnosed with advanced stage,the prognosis is poor.The joint detection of tumor markers contributes to the early diagnosis and treatment monitori-ng of lung cancer.The purpose of this study is to investigate the difference of the expression levels of five tumor markers CEA（carcino-embryonic antigen）、NSE（neuron specific enolase）、CA125（carbohydrate antigen125）、SCCAg（squamous cell carcin-oma antigen）、CYFRA21-1（cytokeratin-19-fragment）in different types of lung cancer and the value of combined detection in the early diagnosis of lung cancer.Methods:The 150 newly diagnosed patients with lung cancer who were hospitalized at the Cancer Center of the First Hospital of Jilin University from January 2016 to December 2016 were selected as the study subjects.All patients were diagnosed by pathological examination and histological type was determined.In the same period,70 patients with benign pulmonary disease who were diagnosed and treated in the Department of Respiratory Medicine at the First Hospital of Jilin University were selected as the control group.All patients received venous blood before the initial treatment and performed five serum tumor markers.To analyze the expression levels of five tumor markers in the lung cancer group and benign lung disease group,and the differences in expression levels in different tissue types of lung cancer,and to evaluate the sensitivity and specificity of the five tumor markers for single and/or combined detection of lung cancer,positive predicti-ve value and negative predictive value,according to the area under the ROC curve to determine the clinical value of the five tumor markers in the early diagnosis of lung cancer.Results:1.The serum levels of CEA,CA125,NSE,SCCAg,and CYFRA21-1 in the lung cancer group were significantly higher than those in the control group（P<0.05）.The difference was statistically significant.2.The expression of CEA and CA125 in lung adenocarcinoma was significantly higher than that in squamous cell carcinoma and small cell lung cancer（P<0.05）.The expression of NSE in small cell lung cancer was significantly higher than that in non-small cell lung cancer（P<0.05）.The expression of SCCAg and CYFRA21-1in squamous cell lung cancer was significantly higher than that in adenocarcinoma and small cell lung cancer（P<0.05）.3.The sensitivity of serum CYFRA21-1 in the diagnosis of lung cancer was 45.33%and the specificity was 81.43%.AUC_ROC（Area Under roc Curve）was 0.704;the highest positive rate was CA125+CYFRA21-1,the positive rate was 51.60%,the AUC_ROCOC was 0.590;the highest triple positive rate was CYFRA21-1+NSE+CA125,the positive rate was 63.40%,the AUC_ROCOC was0.671,and the highest rate of quadruple positive was CEA+CA125+NSE+CYFRA21-1,the positive rate was 69.30%,the AUC_ROCOC was 0.692;the positive rate of the pentane was 71.70%,and the AUC_ROCOC was 0.649.Conclusions:1.CYFRA21-1 is a marker for the diagnosis of lung cancer with high clinical value.In the cases of squamous cell carcinoma,adenocarcinoma and small cell carcinoma,CYFRA21-1 expresses high serum levels,and the sensitivity from high to low is squamous cell carcinoma.adenocarcinoma and small cell carcinoma.2.The specificity of NSE in the diagnosis of small cell lung cancer is the highest,and the clinical significance of differential diagnosis of small cell lung cancer is larger.3.Multiple tumor markers combined detection can effectively improve the sensitivity and positive predictive value of early diagnosis of lung cancer,and the combined detection of CEA+CA125+NSE+CYFRA21-1 is the best.