The Value Of CYFRA21-1,NSE And CEA Levels In Bronchoalveolar Lavage Fluid In Diagnosis Of Lung Cancer

Lung cancer is a malignant tumor originated hi lung. It is one of the most common carcinomas in the whole world. Most patients with lung cancer can be diagnosed by bronchofiberscope biobsy, brush slide pathology, but the others (about 30%) can't be determined. To obtain the diagnosis of lung cancer, some authors have proposed the detection of tumor markers. Cytokeratin 19 fragment(CYFRA21-l), neuron specific enolase(NSE) and carcinoembryonic antigen(CEA) are sufficiently sensitive and specific in diagnosis of lung cancer. No reports have shown the three markers combined detection hi bronchoalveolar lavage fluid(BALF) in internal and overseas literature. The purpose of this study is to evaluate the diagnostic value of the assay CYFRA21-1, NSE and GEA in BALF and to compare with serum assay in patients with lung cancer and benign pulmonary disease.Material and Methods: Lung cancer group consisted of 45 cases, 31 males and 14 females, age 28-72Y, mean age (57.67 ?8.74)Y. All cases had been proven by pathologic diagnosis and previously untreated. According to the histology, 35 cases were non-small cell lung cancer (NSCLC) and 10 cases were small cell lung cancer (SCLC), NSCLC consisted of 21 cases of squamous carcinoma, 13 cases of adenocarcinoma and 1 case of large cell carcinoma. Clinical staging: hi accordance with UICC's TNM system (1997), NSCLC stage I -II 21 cases, stage III-IV 14 cases; In accordance with LASLC's clinical standard (1989), SCLC limited 4 cases, extensive 6 cases. Control group (benign pulmonary disease) consisted of 20 cases, 14 males and 6 females, age 30-76Y, mean age (54.75 ?12.53)Y; Including 4 cases of pulmonary tuberculosis, 6 cases of pneumonia, 9 cases of chronic bronchitis and 1 case of bronchiectasis. CYFRA21-1 and NSE were detected by immunoradiometric assay (IRMA), CEA was detected by radioirnmunoassay (RIA). With SPSS 10.0 software package, because the data is skewness distribution, the descriptive statistics usedChi-Square test, Fisher's exact test and Spearman's rank correlation were used to analyze the data; size of the test was P<0.05.Results: 1. ROC curve determined the best-cut point in BALF: B- CYFRA21-1 was 36.25μg/L, B-NSE was 7.87μg/L, B-CEA was 25.91μg/L; the best cut point in serum: S-CYFRA21-1 was 3.91μg/L, S-NSE was 6.54μg/L, S-CEA was 17.87μg/L. 2. The B-CYFRA21-1 level was significantly higher in lung cancer group than that in control group (P<0.01). In the histological classification of lung cancer, the B-CYFRA21-1 level in squamous cell carcinoma group was significantly higher than that in other groups (P<0.01). 3. The positive rate(62.22%)of B-CYFRA21-1 in lung cancer group was significantly higher than the rate (37.78%)of S-CYFRA21 -1(P<0.05). In the histological classification of lung cancer, the positive rate(90.48%) of B-CYFRA21-1 in squamous cell carcinoma group was significantly higher than that in other groups(P<0.05), furthermore higher than the positive rate(47.62%)of S-CYFRA21-1 in the same group(P<0.01). In stage of I - II of NSCLC, the positive rate of B- CYFRA21-1(71.43%)was significantly higher than the rate(33.33%)of S-CYFRA21-1 in the same group(P<0.05). 4. The B-NSE level in SCLC group was significantly higher than that in NSCLC group(P<0.01); The positive rate(80%)of B-NSE in SCLC group was significantly higher than the rate(40%)of NSCLC group(P<0.05). 5. The B- CEA level in lung cancer group was significantly higher than that in control group(P<0.01). In the histological classification of lung cancer, the B-CEA level in adenocarcinoma group was signigicantly higher than that in other groups (P<0.01). 6. The positive rate(64.44%) of B-CEA was significantly higher than the rate(35.36%)of S-CEA in the same group(P<0.05). In the histological classification of lung cancer, the positive rate(92.31%)of B- CEA in adenocarcinoma group was significantly higher than that in other groups(P<0.05), furthermore higher than the positive rate(46.15%)of S-CEA in the same group(P<0.05). In stage of I - II NSCLC, the positive rate(66.67%)of B-CEA...