Exploring The Correlation Between The Combined Detection Of Serum CA125,NSE,and CEA With Chronic Obstructive Pulmonary Disease Complicated With Lung Cancer And The Study Of Traditional Chinese Medicine Syndrome Types

Objective:A cross-sectional study of clinical data from patients with chronic obstructive pulmonary disease(COPD)and chronic obstructive pulmonary disease combined with lung cancer(COPD-LC),To explore the correlation between CA125,NSE,CEA,CYFRA21-1,D-dimer,FIB and COPD-LC,to provide basic theoretical basis for early screening and diagnosis of COPD-LC and to guide the prevention and treatment of TCM,clinical management and improve clinical efficacy.Methods:A total of 89 patients with simple COPD and COPD-LC who were clearly diagnosed in the Department of Respiratory and Critical Care Medicine of the Fourth Affiliated Hospital of Xinjiang Medical University from January 2021 to February 2023 were selected.The TCM dialectical typing of 89 patients was also analyzed.Results:(1)The prevalence of patients with COPD is greater in men than in women.(2)CA125,NSE,CEA,CYFRA21-1,D-D,and FIB levels were statistically significant in the COPD and COPD-LC groups(P <0.001).(3)The area under the curve of CEA was the largest in the COPD-LC group(AUC=0.899),followed by CA125(AUC=0.841)and NSE(0.826),the combination of CEA,CA125 and NSE with the largest AUC value was selected,the sensitivity and specificity of the combination of CA125,CEA and NSE in detecting COPD-LC were97.29% and 85.19%,respectively,with an AUC area of 0.946.It indicates that the combined CEA,CA125,and NSE test can be used as an informative indicator for early screening of COPD-LC.(4)The comparison of the analysis of pulmonary function in the COPD group and COPD-LC group showed that VCmax% and FVC% were statistically significant in both groups(P<0.05),while the others were not statistically significant in both groups(P>0.05).(5)The classification of the evidence yielded 39.33% for lung spleen deficiency,30.34% for phlegm congestion,and 30.34% for others(dryness injuring the lung,phlegm-heat congestion,phlegm-stasis interconnection).(6)CA125 was statistically significant(P < 0.05)in lung spleen qi deficiency,phlegm congestion,and others(dryness injuring the lung,phlegm-heat congestion,and phlegm-stasis interconnection).Conclusion:1.Combined diagnosis of CA125,CEA and NSE can effectively improve the sensitivity of early screening for COPD combined with lung cancer.2.From the perspective of Chinese medicine,COPD-LC patients and COPD patients are mainly suffering from lung spleen deficiency and phlegm congestion,which indicates that the treatment should be supplemented by tonifying the lung and strengthening the spleen,and at the same time should be supplemented by dispelling phlegm and resolving turbidity.