Clinical Research On Lung Cancer Related Tumor Markers In Serum

Objective To compare the value of neuron-specific enolase(NSE)?carcinoembryonic antigen (CEA), carbohydrate antigen(CA125), squamous cell carcinoma antigen(SCC) and cytokeratin 19 fragment(Cyfra21-1) in the diagnosis and evaluation of lung cancer.Materials and Methods a cohort of 3436 cases diagnosed in the thoracic department of Cancer Hospital and Institute. Chinese Academy of Medical Science were collected. Cases were selected according to the inclusion criteria and exclusion criteria,3009 cases were included. First, to analyze if there is a need for tumor markers detection in a group of patients who had got histopathologic results and (or) cytological results, histopathologic results got after surgery served as "golden standard" for evaluate the reliability of fiberoptic bronchoscopy(FOB) and sputum cytological results. Second, diangnosis and evaluation value of tumor markers in the group of patients who had not got histopathologic results and (or) cytological results were assessed. At the same time. the correlation between tumor markers and age, gender, smoke history, family history of malignant tumors, histopathologic type, differentiation, TNM stage were caculated.Results Results of Fiberoptic bronchoscopy biopsy, bronchofibroscopic specimen brushing and sputum cytology were reliable when used to distinguish primary lung cancer from benign lung diseases with all the positive predictive value>99%, so the function of tumor markers in the group of patients who had got histopathologic results and (or) cytological results is limited. In another group of patients who had not got histopathologic results and (or) cytological results before surgery, the specificity of these five tumor markers are all above 93%with different sensitivities. Cyfra211 and SCC is more sensitive for detection of squamous lung cancer, the sensitivity were 54.84%and 40.32%respectively, and NSE is more specific for detection of SCLC. All the combination detection patterns were tried, the sensitivity ascending and the specificity descending were observed with the detection items added. CEA+NSE and CEA+SCC could be used to distinguish lung cancer from benign lung diseases. CA125+CEA? CA125+Cyfra211?CA125+SCC, CEA+Cyfra21?CEA+SCC, Cyfra211+SCC could be used to distinguish SCLC from NSCLC. Diagnosis model were built to distinguish SCLC from NSCLC, its sensitivity and specificity are all higher than the combination detection, with a positive predictive value of 99.50%. These five tumor markers are related with age, gender, histopathologic type, differentiation and TNM stage?Conclusions Tumor markers is a choice for diagnosis and evaluation of lung cancer because its high specificity, especially Cyfra21-I and SCC for squamous carcinoma, NSE for small cell lung cancer. In the group of patients who had got histopathologic results and (or) cytological results, because the results are reliable, there is not a need for tumor markers detection, but in the group of patients who had not got histopathologic results and (or) cytological results, tumor markers detection assisted with CT detection could provide a reliable diagnosis, especially for NSCLC. And, tumor markers are related with histopathologic type, differentiation and TNM stage, it could be use as a method of evaluation before operation. Background and objective To evaluate and compare the diagnosis value of serum ProGRP and NSE in SCLC with a meta-analysis.Materials and Methods All the English and Chinese published studies for differential diagnosis of SCLC by serum ProGRP and NSE were collected. Sensitivity, specificity, likelihood ratio and diagnostic odds ratio were pooled using random-effect model. Summary receiver operating characteristic curve analysis was used to compare the diagnostic ability of serum ProGRP and NSE.Results Ten studies were included in the meta-analysis, with a total of 2536 cases. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of ProGRP in the diagnosis of SCLC were:0.70,0.93,11.57,0.32 and 36.45, and as for NSE that is 0.61.0.90.5.67.0.45 and 13.08, respectively. The Q* value of ProGRP and NSE were 0.8042 and 0.7232. There was no statistical significance between them.Conclusion Comparing with NSE, ProGRP has higher specificity and similar discrimination ability, so ProGRP might be a better index in the diagnosis of SCLC.