Clinical Utility Of Multiple Tumor Markers In Differential Diagnosis Of Lung Cancer

Objective:To investigate the significance of tumor makers including CEA(carcinoembryonic antigen). CA211(cytokeratin 19 fragment),NSE (neuron specific enolase) and SCC (squamous cell carcinoma-related antigen) in differential diagnosis of lung cancer.Methods:The serum levels of CEA. CA211, NSE and SCC were detected in 115 patients with untreated primary lung cancer and 76 patients with benign pulmonary disease, all of them were treated in 2nd Affiliated Hospital of Zhejiang University from January 2010 to March 2011.The value of these tumor makers in differential diagnosis were analyzed by receiver operative characteristic (ROC) curve.Results:All serum levels of the 4 tumor markers in the patients with lung cancer were significantly higher than those in the patients with benign pulmonary disease (P＜0.05). The level of CEA in adenocarcinoma was significantly higher than that of other pathology types(P<0.05), the level of NSE in small cell lung cancer was significantly higher than that of other pathology types(P<0.05), and the level of SCC in squamous cancer was significantly higher than that of other pathology types(P<0.05). For 1ung cancer, the sensitivity of CEA, CA211, NSE and SCC was 29.57%,15.65%, 6.98%,31.30%, respectively. The sensitivity was increased to 76.67% when four markers were used in combination. CEA was most sensitive to adenocarcinoma(41.38%), NSE was most sensitive to small cell lung cancer(50%), and SCC was most sensitive to squamous cancer(65.63%). If the cut-off value is set to be 3.3ng/ml,CA211 could be much more useful in differential diagnosis of NSCLC and SCLC; Combination of CA211 and CEA, CA211 and NSE,CA211 and SCC greatly increases the diagnostic sensitivity and specificity to adenocarcinoma,small cell lung cancer and squamous cancer.Conclusions:The combined detection of CEA,CA211,NSE and SCC could increase the diagnostic sensitivity of lung cancer. It was proved to be a useful reference for differentiation of the lung cancer and benign lung disease, even for different pathology types.