The Value Of Four Serum Tumor Markers In The Diagnosis Of Lung Cancer

Objective: To study the clinical significance of four serum tumor markers in diagnosis of lung cancer.Methods: Selected the patients who have been treated in Respiratory Medicine,Critical Care Medicine and Oncology Medicine,Wannan Medical College First Affiliated Yijishan Hospital in China,from October 2017 to October 2018.The patients diagnosed as lung cancer and benign lung lesions by histopathological.Detected their serum tumor markers pro-gastrin-releasing peptide(ProGRP),carcinoembryonic antigen(CEA),cytokeratin 19 fragment(CYFRA21-1)and neuron-specific enolase(NSE)respectively,judge the results.Collected the clinical data of patients,finally,statistical methods were used to process the results.Compared with various tumor markers expression level and positive rate,and analyzed the correlation between these four tumor markers alone and the joint examination and the diagnosis of lung cancer.Results: A total of 104 lung cancer patients were collected in this study,including 70 males and34 females,47 cases of lung adenocarcinomas,34 cases of lung squamous cell carcinoma,23 cases of small cell lung cancer.There were 78 cases of benign lung lesions,including 49 males and 29 females,11 cases of chronic obstructive pulmonary disease,6 cases of pulmonary parenchymal diseases,8 cases of bronchiectasis,33 cases of pulmonary infection and 20 cases of pulmonary tuberculosis.The levels of four serum tumor markers,CEA,CYFRA21-1 and NSE,in lung cancer group were significantly higher than those in benign lung lesions group(all P=0.000),and serum ProGRP was also highly expressed in lung cancer patients(P=0.001).In thelung cancer group,the following conclusions can be drawn by comparing the expression levels of tumor markers in squamous cell lung cancer,adenocarcinoma and small cell lung cancer.Serum CEA level was higher in the diagnosis of lung adenocarcinoma(P=0.001).Serum ProGRP and NSE were well expressed in the diagnosis of small cell lung cancer(P=0.000).There was a high level of serum CYFRA21-1 in lung squamous cell carcinoma(P=0.001).The above differences have statistical significance.Based on the detection results of each tumor marker,the ROC curve of lung cancer diagnosis made by them independently was drawn,and the best diagnosis point ProGRP was 74.40,CEA was 2.66,CYFRA21-1 was 2.56,and NSE was 13.195.The data were recombined positively through four optimal diagnostic points,and the regression model was established by Logistic fitting regression,and the ROC curve was drawn according to the regression results.The ROC curve and Logistic regression analysis results showed that the AUC in the diagnosis of benign and malignant lung diseases using ProGRP,CEA,CYFRA21-1 and NSE alone was 0.640,0.751,0.789 and 0.743,respectively,and the AUC in the diagnosis of benign and malignant lung diseases using the above four indexes in combination was 0.860.The sensitivity,accuracy and AUC of the combined detection of ProGRP,CEA,CYFRA21-1 and NSE in lung cancer diagnosis were higher than those of individual detection of each tumor marker,while the specificity and positive predictive value are lower than those of individual detection of each tumor marker,and the difference was statistically significant(all P=0.001).Conclusion: The levels and positive rates of four serum tumor markers,ProGRP,CEA,CYFRA21-1 and NSE,were higher in lung cancer patients than in benign lung diseases.The levels of four serum tumor markers,ProGRP,CEA,CYFRA21-1 and NSE,were expressed differently in different types of lung cancer.Serum CEA levels in lung adenocarcinoma group were higher than those in lung squamous carcinoma group and small cell lung cancer group,and serum CYFRA21-1 levels in lung squamous carcinoma group were higher than those in lung adenocarcinoma group and small cell lung cancer group,the serum levels of ProGRP and NSE in small cell lung cancer group were higher than those in lung adenocarcinoma group and lungsquamous cell carcinoma group.The combined detection of serum ProGRP,CEA,CYFRA21-1and NSE was helpful to improve the sensitivity,accuracy and AUC of early lung cancer screening,while the specificity and positive predictive value were lower than that of individual detection of tumor markers alone.