Clinical Study Of CEA?PROGRP?CYFRA21-1 And SCC In Lung Cancer Diagnosis And Pathological Typing

Objective:By detecting the levels of Carcinoembryonic antigen(CEA),Gastrin-releasing peptide precursor(PROGRP),Cytokeratin 19(CYFRA21-1)and Squamous cell carcinoma antigen(SCC)four tumor markers in the peripheral blood of patients with lung cancer,Objective to explore the diagnostic value of the diagnosis of Lung adenocarcinoma(AD),Lung squamous cell carcinomas(SQC)and Small cell Lung cancer(SCLC).Methods:This study collected 95 patients diagnosed with lung cancer from January 2016 to December 2018 in the second affiliated hospital of kunming medical university as case group,by biopsy and peeling pleural effusion cytology in pathological diagnosis standard,the case group divided into SCLC group of 30 cases,lung adenocarcinoma group of 34 cases,lung squamous carcinoma group of 31 cases,and collect in the same period 90 cases as control group in patients with lung benign disease in hospital,the case group and control group were detected in the serum level of CEA,SCC,PROGRP,CYFRA21-1,whether there is a difference,The sensitivity and specificity of the single and combined detection of the four markers are calculated,and the ROC curves of the three pathological types of lung cancer are drawn to judge the value of CEA,PROGRP,CYFRA21-1 and SCC in lung cancer diagnosis and typing.SPSS software was used for statistical analysis.Results:1 There was no significant difference in gender and age between the lung cancer group and the control group(P>0.05).2 Comparing lung cancer group with control group,the CEA,PROGRP,CYFRA21-1 and SCC levels of the former group are all higher than those of the control group,and the difference is statistically signifi cant(P<0.05).The comparison of four markers in the SCLC group and the lung adenocarcinoma group shows that the former PROGRP level is significantly higher,and the difference is statistically significant(P<0.017),and the CYFRA21-1 level is lower than that in the lung adenocarcinoma group,and the difference is statistically significant(P<0.017).There was no significant difference in CEA and SCC levels between the two groups(P>0.017).The comparison of the levels of four markers between the SCLC group and the lung squamous cell carcinoma group shows that the former PROGRP levels are significantly increased,and the differences are statistically significant(P<0.017).The levels of cyfra21-1 and SCC are lower than those in the lung squamous cell carcinoma group,and the differences are statistically significant(P<0.017).CEA level was compared between the two groups,and the difference was insignificant(P>0.017).The comparison of the levels of four markers between the lung adenocarcinoma group group and the lung squamous cell carcinoma group shows that the CEA level of the lung adenocarcinoma group was higher than that of the lung squamous cell carcinoma group,and the differences are statistically significant(P<0.017),and the SCC level was lower than that of the lung squamous cell carcinoma group and the differences are statistically significant(P<0.017).There are no statistically significant differences between the two groups in PROGRP and CYFRA21-1(P>0.017)3 The specificity of the four tumor markers in the identification of benign and malignant lung diseases was higher than 82%,but the sensitivity had different focuses:the sensitivity of CEA in the detection of lung adenocarcinoma was the highest,67.6%;The sensitivity of CYFRA21-2 and SCC in the diagnosis of lung squamous cell carcinoma was higher(87.1%and 77.4%,respectively).The PROGRP diagnosis of SCLC has the highest sensitivity and specificityCombined detection showed that the diagnostic sensitivity could be increased to 88.42%with the increase of application items,but the specificity of diagnosis could not be improved.4 Taking the benign lung disease group as the control group and the small cell lung cancer group,lung adenocarcinoma group and lung squamous cell carcinoma group as the disease group,respectively,the ROC curve of the ability of four kinds of markers to distinguish different lung cancer types was drawn.As shown in figure 5-7 and table 7,the diagnostic value of the same tumor marker for different pathological types was different.The results showed that CEA was of moderate diagnostic value for SCLC,adenocarcinoma and squamous cell carcinoma,with AUC of 0.714,0.811 and 0.705,respectively.The diagnostic value of PROGRP in SCLC is high,the diagnostic value in adenocarcinoma and squamous cell carcinoma is medium,and the AUC are 0.995,0.838 and 0.732,respectively.CYFRA21-1 has medium diagnostic value;for SCLC and adenocarcinoma,and high diagnostic value for squamous cell carcinoma,with AUC of 0.768,0.883 and 0.914,respectively.SCC has a low diagnostic value for adenocarcinoma and a high diagnostic value for squamous cell carcinoma,with an AUC of 0.615 and 0.911,respectively.All the above results were statistically significant(P<0.05).Conclusion:1 The four tumor markers of lung cancer CEA,PROGRP,CYFRA21-1 and SCC have significant differences between patients in the lung cancer group and those in the benign disease group,which can be used in clinical auxiliary diagnosis of lung cancer.2 The CEA,SCC,PROGRP,CYFRA21-1 four lung cancer tumor markers in the diagnosis of lung cancer pathology classification value each have focused on:the CEA has certain diagnostic value for lung adenocarcinoma,PROGRP is currently one of the best tumor markers in the diagnosis of SCLC,and SCC,CYFRA21-1 are good markers for diagnosis of lung squamous carcinoma,CYFRA21-1 is a good marker for distinguishing SCLC from NSCLC,lung cancer pathology classification can assist judgment,provide a basis for early treatment.3 The combined detection of CEA,PROGRP,CYFRA21-1 and SCC can improve the sensitivity of lung cancer diagnosis,but not the specificity of lung cancer diagnosis.