Clinical Significance In Diagnosing Lung Cancer With The Combined Determination Of Serum Tumor Markers

Research Background and ObjectiveIn recent years,both the incidence and mortality of primary lung cancer (LC) have been on the rise,with its mortality rate ranking first of all cancer deaths.Therefore,it is of great significance to raise the diagnostic and treatment levels of LC.Serum turner marker(TM) is one of the major research topics of modern oncology while the serum detection of LC has become an important target for the diagnosis of the malignancy.However,a single TM would not be satisfactory in sensitivity and speciflcirty,which shows its limitations in the diagnosis of LC.Thus,for the LC patients,we have conducted combined detection of the Lung Tumor-associated Antigen(LTA), Cytokeratin Fragment Antigen 21-1 (CYFRA21-l),Carcinoembryonic Antigen(CEA) and Neuron Specific Enolase(NSE) in the diagnosis of this mortal disease,the aim ofthis study is to evaluate the role of the combined detection in the diagnosis of lung cancer.MethodsIn our series, patients were divided into three groups :Lung cancer(LC) group, benign lung disease(BLD) group and control group. The LC group was subdivided into two subgroups: non-small cell lung cancer(NSCLC) subgroup and small cell LC subgroup (SCLC). The NSCLE patients were further divided into squamous cell carcinoma subjects and conducted adenocarcinoma patients.The latex agglutination(LA)assay was performed to measure the LTA level of all the subjects. Radioimmunoassay(RIMA) was performed to detect the CYFRA21-1, CEA and NSE.The evident data about the contrasts among various groups were found through variance analysis while xa was done to compare the positive rates.Results1 The positive rates of these tumor markers in NSCLCU SCL. BLD and normal control group were 76.8%,29.4%,13.0%,6.06% (LTA) respectively; 73.2%,29.4%,11.2%,and 0% (CYFRA21-1) respectively; 32.9%,82.3%,9.6% and 0% (NSE)respectively; 74.4%,35.3%,10%,and 0% (CEA) respectively.2 The specificity and sensitivity of these tumor markers in LC diagnosis showed 87.3%,and 68.7% respectively in LTA, 94.0% and 65.7% respectively in CYFRA21-1; 84%, and 41.4% in NSE and 96% and 67.7% respectively in CEA.3 The positive rates of LTA in NSCLC,CYFRA21-1 ,NSE and CEA in LC patients were much higher than those in BLD patients and normal control with significant difference between them (P<0.01).4 The positive rates of LTA in NSCLC, CYFRA21-1 in squamous carcinoma, CEA in adenocarcinoma and NSE in SCLC were 76.8%,84.6%,81.4% and 82.3% respectively with significant difference between them (P<0.01).Obviously there was a correlation between their positive rates and the pathological types of LC.5 The serum levels of LTA,CYFRA21-1,CEA and NSE in stage III and stage IV patients were much higher than that in stage I and stage II counterparts with significant difference between them (P0.01).6.The positive rates of combined detection of LTA,CYFRA21-1,CEA and NSE were higher than detecting one or three of the above four items. The positive rates of the combined detection for early LC diagnosis increased to 63.3%.Conclusion1 LTA assay ,a worthwhile TM, is quick, simple and sensitive method in the discrimination of the LC from BLD.2 Of the LTA positive rates, the NSCLC is the highest.which can aid its diagnosis.3 CYFRA21-1 , NSE and CEA are of some value for LC diagnosis .squamous carcinoma has the highest CYFRA21-1 positive rates,whereas pulmonary adenocarcinoma shows the highest CEA positive rates.Regarding SCLC, the highest positive rates are found in NSE.4 The united detection of LTA,CYFRA21-1,CEA and NSE is a valuable cimbination,which can raise LC detection rate,being especially advisable for an early diagnosis of LC and for its effective treatment.