Significance Of TAP Combined With CEA,Cyfra21-1 And SCC-Ag In The Diagnosis Of Lung Cancer

Objective: To compare the expression level of serum tumor abnormal protein(TAP),carcinoembryonic antigen(CEA),cytokeratin 21 fragment antigen(Cyfra21-1)and squamous cell carcinoma antigen(SCC-Ag) in patients with lung cancer.The purpose of this study is to provide a reference for the diagnosis and treatment of lung cancer.Methods:From October 2015 to October 2017,123 patients with lung cancer who were diagnosed as lung cancer in the first hospital of Jiaxing,Department of Respiratory Medicine and Oncology were selected as the observation group,and63 cases of benign lung disease in our hospital were selected as control group.The level of TAP was measured by agglutination reaction,and the serum levels of CEA,Cyfra21-1 and SCC-Ag were detected by electrochemical methods(ECLA).The database is established by EXCEL,and the statistical processing is performed by SPSS 22.0.The measurement results were expressed as mean±standard deviation.The t-test was used for comparison between groups.The comparison of count data and rate was performed by chi-square test,and the comparison between groups was performed by Fisher’s test.Sensitivity,specificity,accuracy,Youden index and the ROC curve were used to evaluate the efficacy of the four indicators alone and in combination with the diagnosis of lung cancer.Results: The positive rates of serum TAP,CEA,Cyfra21-1 and SCC-Ag in lung cancer patients were significantly higher than those in the benign lung lesions(P<0.05).All four indexes could be used as reference tumor markers for diagnosis of lung cancer.The sensitivity of TAP,CEA,Cyfra21-1 and SCC-Ag in the diagnosis of lung cancer was 82.93%,39.02%,40.65% and 20.33%,respectively,and thespecificity was 73.02%,92.06%,88.89% and 88.89%,respectively.The correct rate was 29.57%,56.99%,56.99% and 43.55%,the Youden index is 55.95%,31.08%,29.54% and 9.22%.In the single test,the highest sensitivity,correct rate and Youden index are TAP,the highest specificity is CEA.Among the four indexes of TAP,CEA,Cyfra21-1,SCC-Ag,TAP+ CEA has the highest accuracy and sensitivity in the six combinations,which are 83.87% and 93.50%,respectively,and the highest specificity was CEA+SCC-Ag.It was 87.30%,and the highest index of Youden was the combination of TAP+CEA.The combination of three indicators combined detection TAP+CEA+Cyfra21-1 in the sensitivity and accuracy of the four combinations.The highest is 95.93% and 83.87%.The highest specificity is Cyfra21-1+SCC-Ag+CEA,which is 82.54%.The highest Youden index is TAP+CEA+Cyfra21-1.The combined detection accuracy of the four indicators was 83.87%,the sensitivity was 95.93%,the specificity was 60.32%,and the Youden index was 56.25%.Combined with the ROC curve,these indicators were compared in combination.According to the preferential method and practical principle,the combination of TAP and CEA combined with Cyfra21-1 was the best combination for lung cancer diagnosis.In different TNM stages of lung cancer,the expression levels of TAP,CEA,Cyfra21-1,and SCC-Ag were statistically different in stages Ⅰ～Ⅱ and Ⅲ～Ⅳ,except that the positive rate of TAP was not significantly different between the two components,and the positive rates of the other three tumor markers were in the two groups.There was statistical difference in stage Ⅰ～Ⅱ,Ⅲ～Ⅳ(P<0.05).Serum TAP aggregated particles in four different pathological types of lung adenocarcinoma,lung squamous cell carcinoma,small cell lung cancer and other types of lung cancer.There was no statistical difference in area and positive rate.CEA had a higher positive rate in small cell lung cancer,but there was no significant difference in the positive expression rate among the four pathological types(P>0.05).SCC-Ag was found in lung squamous cell carcinoma.There was a significant difference in the expression of squamous cell carcinoma andadenocarcinoma,squamous cell carcinoma and small cell lung cancer(P<0.001,P=0.025).There was no significant difference between the other pathological types(P>0.05).The expression rate of Cyfra21-1 was higher in lung squamous cell carcinoma,and there was statistical difference between lung adenocarcinoma and squamous cell carcinoma(P<0.001).There was no significant difference between the two pathological types(P>0.05).Conclusions: The combination of serum TAP,CEA,Cyfra21-1 and SCC-Ag can help the diagnosis of lung cancer.Combined detection of TAP,CEA and Cyfra21-1 can be used as an optimal combination of the auxiliary diagnosis of lung cancer in different combinations of indicators.