The Clinical Value Of Combination Of PCT,NSE And CEA In Serum For Diagnosis And Prognosis In Small Cell Lung Cancer

BackgroundThe morbidity and mortality of lung cancer rank first among all malignant tumors in China.Small cell lung cancer(small cell lung cancer,SCLC)accounted for about 15% of the proportion of lung cancer to 20%,calcitonin original(Procalcitonin,PCT)as indicators of inflammation is widely certification,about its clinical application value of research in recent years increasingly update,new study confirmed by measuring the content of serum PCT can provide the basis for the diagnosis of SCLC,is expected to become markers for early diagnosis.Currently,common clinical markers of lung cancer include serum NSE,cyfra2l-1,CEA,etc.Since the sensitivity and specificity of a single tumor marker are not ideal,the combined detection of multiple serological markers can effectively improve the diagnosis of lung cancer.In this paper,through the detection and analysis of serological PCT,NSE and CEA,the diagnostic value of combined detection of three serological markers of different combinations in SCLC was discussed.ObjectiveTo investigate the value of PCT,CEA and NSE combined detection of three serological markers in the diagnosis and cancer staging of SCLC,and to monitor the changes of their index levels in the treatment process for the evaluation of efficacy and prognosis of clinical significance.Materials and methodsWe chose lung cancer patients admitted to the respiratory department of the first affiliated hospital of zhengzhou university from January 2016 to December 2017,excluding pulmonary infection and other infections,with clear pathological or cytological diagnosis,and receiving 4 cycles or more of chemotherapy,were divided into small cell carcinoma group,adenocarcinoma group and squamous cell carcinoma group.Clinical data including age,gender,height,weight,smoking history,clinical symptoms,signs,tumor stage,blood routine,inflammatory index(PCT,CRP),tumor markers(CEA,NSE),pathological data and imaging data were collected before and after chemotherapy,and statistical analysis was performed.At the same time,healthy subjects who underwent outpatient physical examination in the same period were selected as the control group,whose physical examination data were collected and statistically analyzed.SPSS21.0 statistical software was used to describe the quantitative data to mean standard deviation((?) ± s).Analysis of variance and SNK test were used for comparison between groups.The receiver-operating characteristic curve(ROC curve)was used to analyse joint detection of PCT,NSE and CEA in the diagnosis of SCLC and the indicators of effectiveness.Qualitative data were expressed as a percentage(%),and comparison between groups was conducted by χ2 test.Test standard: P < 0.05 means the difference is statistically significant.Results142 lung cancer patients,aged 34-72 years,average age 50.3 ±11.9 years,92 males and 50 females,met the criteria.There were 47 cases in the small cell carcinoma group,45 cases in the adenocarcinoma group,and 50 cases in the squamous cell carcinoma group.In the healthy control group,40 patients were aged 38-69 years old,with an average age of 46.3±9.7 years,including 26 males and 14 females.There was no significant difference in basic data between the groups(P > 0.05).Serum PCT and NSE levels in SCLC group were significantly higher than those in adenocarcinoma group,squamous cell carcinoma group and control group,with statistically significant differences(P < 0.01).The optimal cut-off point of PCT,NSE and CEA for the differential diagnosis of small cell lung cancer,squamous cell carcinoma and adenocarcinoma was 0.115ng/mL,16.56ng/mL and 3.71ng/mL,respectively.The area under the ROC curve was 0.763,0.889 and 0.646,respectively.The sensitivity of PCT,NSE and CEA was 61.7%,77.9% and 59.6%,respectively.Combined detection of PCT+NSE+CEA increased the sensitivity to 89.4%,specificity to 88.6%,and accuracy to 92%.Stage Ⅲ/Ⅳ serum PCT and NSE levels of SCLC patients were significantly higher than that of stage Ⅰ/Ⅱ patients,with statistically significant differences(P < 0.01).After chemotherapy,the levels of NSE and PCT in the CR+PR group of SCLC patients were significantly lower than those before chemotherapy(P < 0.05).There were no significant changes in PCT,NSE and CEA levels before and after chemotherapy in SD+PD group(P > 0.05).Before chemotherapy,the efficacy of NSE and CEA in the normal group was significantly better than that in the elevated group,and the difference was statistically significant(P<0.05).After chemotherapy,the efficacy of PCT and NSE in the normal group was significantly better than that in the elevated group,and the difference was statistically significant(P < 0.05).ConclusionThe detection of serum PCT level can provide a basis for the diagnosis of SCLC.It can also be used as a tool to assist the identification of small cell lung cancer from other pathological types of lung cancer.Compared with the detection of any one or two markers of PCT,NSE and CEA,the detection of three tumor markers of CEA,PCT and NSE is helpful for the diagnosis and pathological typing of lung cancer.Monitoring the changes of PCT,NSE and CEA markers before and after SCLC chemotherapy is helpful to evaluate the efficacy and prognosis of patients after chemotherapy.