Objective: To evaluate the clinical value of serum tumor markers in the diagnosis and classification of lung cancer. Methods: A total of 119 patients with lung cancer admitted to the Department of Respiratory and Critical Care Medicine of the First Affiliated Hospital of Bengbu Medical College from January to October 2023 were selected as the study group, and 54 patients with benign lung tumors in the same period were selected as the control group. The content of serum tumor markers carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC), cytokeratin fragment (CYFRA21-1), neuron-specific enolase (NSE) and gastrin-releasing peptide precursor (ProGRP) in each group was detected and the diagnostic efficacy was analyzed. Results: The serum tumor markers in the study group were higher than those in control group (P<0.05). The CEA content of adenocarcinoma group was higher than that of squamous cell carcinoma group and small cell carcinoma group (P<0.05), the contents of SCC and CYFRA21-1 in squamous cell carcinoma group were higher than those in the adenocarcinoma group and small cell carcinoma group (P<0.05), the levels of NSE and ProGRP in the small cell carcinoma group were higher than those in the adenocarcinoma group and squamous cell carcinoma group (P<0.05). The AUC of CEA detection for adenocarcinoma was 0.987, that of SCC and CYFRA21-1 detection for squamous cell carcinoma was 0.994 and 0.957, and that of NSE and ProGRP detection for small cell carcinoma was 0.923 and 0.944. The AUC (0.991, 0.997, 0.996) of the combined tests for adenocarcinoma, squamous cell carcinoma and small cell carcinoma were higher than those in separate tests (P<0.05). Conclusion: Serum tumor markers have a high guiding value in the definite diagnosis of lung cancer and the differentiation of pathological types. CEA has a high diagnostic value in adenocarcinoma, as well as SCC and CYFRA21-1 in squamous cell carcinoma, and NSE and ProGRP in small cell carcinoma. The combination of the above serum markers can improve the diagnostic efficiency of different pathological types of lung cancer.
MA Mengting
,
FENG Jie
,
WU Nan
,
ZHANG Lunjun
. Value of combined detection of serum tumor markers in the diagnosis and pathological classification of lung cancer[J]. Journal of Baotou Medical College, 2024
, 40(10)
: 23
-27
.
DOI: 10.16833/j.cnki.jbmc.2024.10.005
[1] Nooreldeen R, Bach H. Current and future development in lung cancer diagnosis[J]. Int J Mol Sci, 2021, 22(16): 8661.
[2] 赫捷, 李霓, 陈万青, 等. 中国肺癌筛查与早诊早治指南(2021, 北京)[J]. 中华肿瘤杂志, 2021, 43(3): 243-268.
[3] 田刚, 张章, 刘靳波, 等. 基于血清四项肿瘤标志物的模式识别技术对肺癌的鉴别诊断[J]. 实用医学杂志, 2020, 36(5): 655-660.
[4] 季孝, 吴晓, 余璟璐. 5种血清肿瘤标志物在肺癌早期诊断中的价值研究[J]. 中国卫生检验杂志, 2023, 33(4): 451-454.
[5] 张德宝. LDCT联合血清相关肿瘤标志物水平检测对Ⅰ~Ⅱ期非小细胞肺癌患者诊断价值的影响[J]. 临床研究, 2021, 29(4): 136-137.
[6] 孙伟玲, 张明辉, 吴华星, 等. 血清肿瘤标志物对肺癌患者支气管镜活检病理组织学分型的预测价值[J]. 实用肿瘤学杂志, 2022, 36(4): 316-322.
[7] 郭新蕾. NSE、CEA、SCC在肺癌病理类型鉴别诊断中的应用效果分析[J]. 罕少疾病杂志, 2023, 9(9): 48-49.
[8] 中华医学会肿瘤学分会, 中华医学会杂志社. 中华医学会肿瘤学分会肺癌临床诊疗指南(2021版)[J]. 中华医学杂志, 2021, 101(23): 1725-1757.
[9] 齐艳春, 陈玲玲, 全勍, 等. ProGRP、CEA、NSE、CYFRA21-1、CA125、SCC对不同病理类型肺癌的诊断价值及联合检测的临床意义[J]. 牡丹江医学院学报, 2023, 44(3): 62-66.
[10] Dall′Olio FG, Abbati F, Facchinetti F, et al. CEA and CYFRA 21-1 as prognostic biomarker and as a tool for treatment monitoring in advanced NSCLC treated with immune checkpoint inhibitors[J]. Ther Adv Med Oncol, 2020, 12: 1758835920952994.
[11] Zhang JY, Wei Q, Dong D, et al. The role of TPS, CA125, CA15-3 and CEA in prediction of distant metastasis of breast cancer[J]. Clin Chim Acta, 2021, 523: 19-25.
[12] 邵莹, 张强, 翁文娟, 等. 血清肿瘤标志物联合检测在肺癌诊断及分型中的价值[J]. 牡丹江医学院学报, 2022, 43(2): 25-28, 32.
[13] Qiao YF, Chen CG, Yue J, et al. Tumor marker index based on preoperative SCC and CYFRA 21-1 is a significant prognostic factor for patients with resectable esophageal squamous cell carcinoma[J]. Cancer Biomark, 2019, 25(3): 243-250.
[14] Yang QX, Zhang P, Wu RQ, et al. Identifying the best marker combination in CEA, CA125, CY211, NSE, and SCC for lung cancer screening by combining ROC curve and logistic regression analyses: is it feasible[J]. Dis Markers, 2018, 2018: 2082840.
[15] van Schaik JE, Muller Kobold AC, Van Der Laan BFAM, et al. SCC antigen concentrations in fine-needle aspiration samples to detect cervical lymph node metastases: a prospective analysis[J]. Otolaryngol Head Neck Surg, 2023, 168(3): 407-412.
[16] 莫国新, 李广志, 梁晓明. 血清肿瘤标志物检测对肺癌患者的诊断意义分析[J]. 中国处方药, 2021, 19(2): 143-144.
[17] 张雷, 葛淼. 中国健康人群肿瘤标记物CYFRA21-1参考值的空间分布[C]//中国环境科学学会2022年科学技术年会论文集(三). 南昌, 2022: 199-206.
[18] 赵宝祥, 李华, 张亚君, 等. 胃泌素释放前体、神经元特异性烯醇化酶和癌胚抗原在小细胞肺癌中的诊断价值[J]. 癌症进展, 2020, 18(10): 1012-1014, 1022.
[19] 余剑桥, 周俊, 付海琴. CYFRA21-1、LDH联合NSE检测辅助诊断肺癌及与TNM分期的关系[J]. 分子诊断与治疗杂志, 2021, 13(10): 1619-1622.
[20] 余立峰, 魏修奇, 王晖. CEA、CYFRA21-1、SCC和NSE在肺癌诊断、分型、分期和治疗中的综合应用[J]. 国际检验医学杂志, 2023, 9(13): 1641-1645.
[21] 张知, 吴芳, 朱春梅, 等. 6种血清肿瘤标志物用于肺癌诊断中的积极意义及临床诊断价值分析[J]. 江西医药, 2022, 57(6): 664-665, 669.
[22] 程明, 王伟伟, 吕世琪, 等. CEA、CA125、CYFRA21-1、NSE及SCC对NSCLC诊断和化疗效果评估的临床价值[J]. 分子诊断与治疗杂志, 2022, 14(7): 1099-1103.