Clinical Value Of Combinating Detection Of CEA,CYFRA21-1, NSE In Early Diagnosis Of Lung Cancer

Objective: Lung cancer is one of the most common malignant tumors of the respiratory system, and has become the main cause of death caused by cancer. In recent years, although the technology has got great progress in treatment of lung cancer patients, the 5 year survival rate has not been improved significantly. The survival rate of lung cancer depends on improving the early diagnosis and treatment technology, therefore, the early diagnosis of lung cancer is extremely important to investigate clinical value of combinating with detection of carcinoembryonic antigen(CEA); cytokeratin 19 fragment 21-1(CYFRA21-1); neuron specific enolase(NSE) in lung cancer early diagnosis.Methods: 126 untreated patients with lung cancer in our hospital from Jan,2012 to Dec 2014,were included into lung cancer group. 143 patients with benign lung disease were selected and included into benign disease group;another 26 healthy persons were selected as healthy control group, the difference of serum CEA,CYFRA21-1,NSE levels among three groups was compared, The CEA,CYFRA21-1, NSE levels and positive expression conditions of patients with different types of lung cancer were compared, and the sensitivity and specificity were compared between single detection and combined detection.Results: The CEA level of The healthy control group, lung cancer group, benign disease group were 1.26±0.91 ng/ml,16.54±6.57 ng/ml,1.59±1.04 ng/ml respectively. The CYFRA21-1 level were 1.02±0.35 ng/ml,13.81±9.82 ng/ml,1.22±0.51 ng/ml respectively.The NSE level were 12.40±5.75ng/ml, 35.75±18.43 ng/ml,13.25±6.12 ng/ml respectively. the serum CEA,CYFRA21-1, NSE levels of patients in lung cancer group were significantly higher than those in healthy control group, benign disease group(P < 0.05).The CEA level of the Squamous cell carcinoma, adenocarcinoma, small cell carcinoma, undifferentiated carcinoma were 8.83±1.74 ng/ml,23.92±5.62 ng/ml,9.24±2.03 ng/ml,22.21±5.26 ng/ml respectively. The CYFRA21-1 level were 17.38±3.24 ng/ml,10.16±3.01 ng/ml,9.85±2.71 ng/ml,16.34±2.82 ng/ml respectively. The NSE level were 21.45±9.24 ng/ml,22.28±10.51 ng/ml,47.82±13.05 ng/ml,24.91±9.54 ng/ml respectively. the serum CEA in adenocarcinoma patients was significantly higher than that in squamous cell carcinoma, small cell carcinoma patients(P < 0.05); the CYFRA21-1 level in squamous cell carcinoma patients was significantly higher than that in adenocarcinoma, small cell carcinoma patients(P < 0.05);the serum NSE in small cell carcinoma patients was significantly higher than that in squamous cell carcinoma,adenocarcinoma, undifferentiated carcinoma patients(P < 0.05).The CEA positive expression rate of Squamous cell carcinoma, adenocarcinoma, small cell carcinoma, undifferentiated carcinoma were 8(23.52) %, 21(50.00) %, 8(22.22) %, 9(64.29) % respectively.the CYFRA21-1 positive expression rate were 26(76.47) %,23(54.76) %,13(36.11) %,8(57.14) % respectively. The NSE positive expression rate were 22(64.71) %,25(59.52) %,34(94.44) %,9(64.29) % respectively. The positive expression of CEA in different types of lung carcinoma, undifferentiated carcinoma was the highest, followed by adenocarcinoma; the CYFRA21-1 positive expression rate in squamous cell carcinoma patients was highest; the NSE positive expression rate in small cell carcinoma patients was highest(P < 0.05).The Sensitivity of CEA,CYFRA21-1, NSE,CEA+ CYFRA21-1+ NSE were 27.30%,68.91%,65.75%,82.15% respectively.the Specificity were 22(64.71) %,25(59.52) %,34(94.44) %,9(64.29) % respectively. Among alone detection,the CYFRA21-1 sensitivity was the highest,the CEA specificity was the highest, Among combinated detection,the sensitivity was increased to 82.15%, but the specificity was reduced to 59.25%.Conclusions: The early diagnosis of lung cancer just rely on a kind of detection method can’t be completed. Application of ECLICA method, CYFRA21-1 combined detection of CEA and NSE, the sensitivity of the diagnosis of lung cancer has been greatly improved, which is of great significance for early screening of lung cancer.