| Objective:By collecting the laboratory test results of tumor markers,the diagnostic value of these markers in lung cancer was observed and the clinical significance of these markers in lung cancer was emphatic discussed.Methods:A total of 144 patients with lung cancer diagnosed by pathology and immunoh istochemistry,with definite pathological types.They were selected from the Department of Respiratory and Critical Care Medicine,Department of Thoracic Surgery,Department of Oncology,from September 2017 to September 2020.Besides,the address was The First Affiliated Hospital of Xi ’an Medical College.The data of age,gender,tumor markers level and pathological examination results were collected.Mann-Whitney U nonparametric test was used to analyze the differences between the two groups.Receiver-operating characteristic curve was used to evaluate the diagnostic efficacy of tumor markers.The cut-off point corresponding to the maximum Yoden index was used as the optimal diagnostic critical point,and used to calculate the sensitivity and specificity of tumor markers in the detection of lung cancer.Results:1.The expression level of serum proGRP in small cell lung cancer group was significantly higher than that in non-small cell lung cancer group(P﹤0.05).The expression levels of SCCA and CYFRA21-1 in NSCLC group were significantly higher than those in small cell lung cancer group(P﹤0.05).The expression levels of serum tumor markers,CEA,CA199,were no significantly difference between the small cell lung cancer group and the non-small cell lung cancer group(P>0.05).2.Using non-small cell lung cancer group as the control group,the AUC of proGRP for the diagnosis of small cell lung cancer was 0.943,the sensitivity was 87.5%,the specificity was 95.2%,and the optimal cut-off value was 65.12pg/ml.3.The expression level of serum proGRP in small cell lung cancer group was significantly higher than that in squamous cell carcinoma group(P﹤0.05).The expression levels of SCCA and CYFRA21-1 in squamous cell carcinoma group were significantly higher than those in small cell lung cancer group(P﹤0.05).There were no statistical significance in the expression levels of tumor markers,CEA,CA199 between the small cell lung cancer group and the squamous cell carcinoma group(P>0.05).4.Using squamous cell carcinoma group as control group,the AUC of proGRP for the diagnosis of small cell lung cancer was 0.951,the sensitivity was 87.5%,the specificity was 96.3%,and the optimal cut-off value was 65.12pg/ml.5.The expression level of serum proGRP in small cell lung cancer group was significantly higher than that in adenocarcinoma group(P﹤0.05).The expression levels of tumor markers,SCCA,CYFRA21-1 and CEA in adenocarcinoma group were significantly higher than those in small cell lung cancer group(P﹤0.05).There was no significant difference in the expression level of CA199,between the small cell lung cancer group and the adenocarcinoma group(P>0.05).6.With adenocarcinoma group as control group,proGRP had the highest area under curve,AUC was 0.935,and the optimal cut-off value was 64.62pg/ml.Besides,sensitivity was 87.5%,specificity was 94.0%.7.The expression levels of serum SCCA and CYFRA21-1 in squamous cell carcinoma group were higher than those in adenocarcinoma group(P﹤0.05).The expression levels of serum CEA and CA199 in adenocarcinoma group were higher than those in squamous cell carcinoma group(P﹤0.05).8.Using adenocarcinoma group as control group,the AUC of CYFRA21-1 in the diagnosis of squamous cell carcinoma was 0.75,the sensitivity was 81.5%,the specificity was 68.0%,and the optimal cut-off value was 11.68ng/m L.The area under the SCCA curve was 0.729,the sensitivity was 61.1%,the specificity was 84.0%,and the optimal cut-off value was 1.55ng/m L.When squamous cell carcinoma group was used as control group,the AUC of CEA in the diagnosis of adenocarcinoma was 0.749,the sensitivity was46.0%,the specificity was 94.4%,and the optimal cutoff value was 15.47ng/m L.The area under the curve of CA199 was 0.643,the sensitivity was 50.0%,the specificity was 79.6%,and the best cut-off value was 28.44U/m L.Conclusions:1.Pro GRP is a good marker for the diagnosis of small cell lung cancer,and can be used for the differential diagnosis of small cell lung cancer and non-small cell lung cancer,squamous cell carcinoma,and small cell lung cancer and adenocarcinoma.2.CYFRA21-1、CEA are good tumor markers for the diagnosis of squamous cell carcinoma and adenocarcinoma,respectively.It can be used for the differential diagnosis of squamous cell carcinoma and adenocarcinoma. |
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