Clinical Significance Of Serum CEA,VEGF Combined With Ki-67 In Patients With Lung Cancer

BackgroundIn recent years,the incidence and mortality of lung cancer in China are the highest among malignant tumors.The detection of tumor markers plays an important role in the diagnosis and treatment of lung cancer.Among them,the serum carcino-embryonic antigen(CEA)is a common indicator of early screening,vascular endothelial growth factor(VEGF)is the key factor of tumor angiogenesis.High expression of VEGF in lung cancer cells plays an important role in energy metabolism,neovascularization,tumor invasion,development and metastasis.Ki-67 is widely used to evaluate the prognosis of lung cancer patients.In this paper,CEA,VEGF,Ki-67 expression levels in lung cancer patients were analyzed to analyze their impact on prognosis.ObjectiveTo explore the relationship between the expression level of CEA,VEGF and Ki-67 in lung cancer patients and their clinicopathological characteristics,and to analyze the influence of CEA,VEGF and Ki-67 on the prognosis of lung cancer patients.MethodsFrom June 2017 to June 2018,lung cancer patients were selected from Henan Provincial People's Hospital.All the patients in the group were diagnosed as lung cancer by pathology,and they visited our hospital for many times and signed the informed consent.Without anytreatment at the first admission of each patient,the serum CEA and VEGF were detected by chemiluminescent detection.The pathological tissues were detected by immunohistochemistry.The Ki-67 value was recorded,and the clinical and pathological characteristics such as sex,age,smoking history,differentiation degree,lymph node metastasis,TNM stage and diagnosis mode were recorded.The progression free survival(PFS)was recorded.The effects of CEA,VEGF and Ki-67 on PFS were analyzed.Results1.A total of 155 lung cancer patients were included,107 males and 48 females,aged27-81 years,including ? 60 years old(n=97)and < 60 years old(n=58),with smoking history(n=99)and without smoking history(n=56),77 in adenocarcinoma group,35 in squamous cell carcinoma group and 43 in small cell carcinoma group,60 in highly differentiated group,95 in moderately and poorly differentiated group,111 in lymph node metastasis group and 44 in non lymph node metastasis group,33 in TNM stage I and stage II group.There were 122 cases of stage ? and ?.The main method of diagnosis was tracheoscopy(n=88,56.8%),followed by CT guided percutaneous lung puncture(n=55,35.5%),and postoperative specimens(n=7,4.5%).2.There was significant difference in pathological types of patients with high CEA expression(P < 0.05).The incidence of high CEA expression was the highest in lung adenocarcinoma patients,followed by lung squamous cell carcinoma and small cell lung cancer.There was no significant difference in gender,age,smoking history,differentiation degree,lymph node metastasis and TNM stage(P > 0.05).There was no significant difference in gender,age,smoking history,pathological type,differentiation degree,lymph node metastasis and TNM stage in patients with high VEGF expression(P > 0.05).There was a significant difference in the pathological type of Ki-67 positive patients(P < 0.05).Theincidence of Ki-67 positive in small cell lung cancer patients was the highest.The incidence of Ki-67 positive in squamous cell carcinoma and adenocarcinoma of the lung decreased in turn.There was no significant difference in gender,age,smoking history,differentiation degree,lymph node metastasis and TNM stage(P > 0.05).3.There was no significant difference between patients with high CEA expression(56.8%,88 / 155)and patients with low CEA expression(17.3 � 5.7 months vs.13.6 � 6.8months)(?2= 0.963,P = 0.326);patients with high VEGF expression(34.8%,54 / 155)and patients with low VEGF expression(14.5�6.0 months vs.16.4�6.6 months)(?2 = 2.353,P =0.125);patients with Ki-67 positive(41.9%,65 / 155)had no significant difference in PFS(13.6�6.2 months)was lower than that of Ki-67 negative patients(17.3�6.3 months)(?2 =14.312,P < 0.001).4.In 155 lung cancer patients,the positive rate of Ki-67 was 37.5%,33 / 88 in those with high CEA expression and 47.8%,32 / 67 in those with low CEA expression,the difference was not statistically significant(?2 = 1.645,P = 0.200).The positive rate of Ki-67 was 46.3%,25 / 54 in the high VEGF expression group and 39.6%,40 / 101 in the low VEGF expression group,with no significant difference(?2= 0.647,P = 0.421).5.In 155 patients with lung cancer,there was no correlation between CEA level in peripheral blood and Ki-67 expression level in lung cancer(r = 0.092,P = 0.256);VEGF level in peripheral blood and Ki-67 expression level in lung cancer(r = 0.095,P = 0.239);CEA level in peripheral blood and VEGF level was not correlated(r = 0.130,P = 0.108).Conclusion1.High CEA expression was the highest in adenocarcinoma,Ki-67 positive in small cell lung cancer,VEGF high expression in lung cancer pathological type had no tendency.2.The PFS of Ki-67 positive patients was lower than that of Ki-67 negative patients.Ki-67 had a predictive effect on PFS of lung cancer patients.The survival period of Ki-67 positive patients was shorter.CEA and VEGF had no predictive effect on PFS.3.There was no correlation between the expression level of CEA and VEGF in lung cancer and the positive expression of Ki-67.