Clinical value of tumor marker detection in diagnosis of lung cancer

Zhang Guo; Zhang Tianci; Wang Feng

doi:10.3969/j.issn.1674-7151.2024.01.009

Abstract：Objective To investigate the clinical value of tumor marker detection in the diagnosis of lung cancer.Methods A total of 310 patients with lung cancer treated in Tai'an Cancer Prevention and Control Hospital from July 2020 to July 2022 were selected as lung cancer group,310 patients with benign lung diseases admitted during the same period were included in lung disease group,and 310 healthy physical examiners during the same period were included in healthy control group.The levels of tumor markers were detected in all three groups.The levels of carcinoembryonic antigen(CEA),carbohydrate cancer antigen 125(CA125),cytokeratin 19 fragment(CYFRA21-1),squamous cell carcinoma antigen(SCC)and neurospecific enolase(NSE)were measured using fully automated electrochemiluminescence immunoassay analyzer.The detection results and positive rates of tumor markers in each group werecompared,and the detection results of the above indicators were compared in patients with different pathological types of lung cancer and different tumor stages.Results The positive detection rate of single index and combined detection in lung cancer group was significantly higher than that in lung disease group[CEA(μg/L):10.80±2.34 vs.4.26±0.75;CA125(kU/L):84.79±8.42 vs.29.26±4.07;CYFRA21-1(μg/L):42.14±5.64 vs.2.57±0.53;SCC(μg/L):4.77±1.02 vs.1.30±0.34;NSE(μg/L):25.16±4.38 vs.12.23±2.01;all P＜0.05].The levels of all the indexes in healthy control group were lower than those in other two groups,and the differences were statistically significant.In the lung cancer group,patients with squamous cell carcinoma had the lowest CEA level,and those with adenocarcinoma had the highest CEA level;patients with adenocarcinoma,squamous cell carcinoma and small cell lung cancer had CA125 and CYFRA21-1 levels from high to low;patients with NSE levels from low to high were adenocarcinoma,squamous cell carcinoma and small cell lung cancer;and patients with SCC levels from high to low were squamous cell carcinoma,small cell lung cancer and adenocarcinoma.The test values of five tumor markers increased with T1,T2 and T3 stages,and the differences were statistically significant.The diagnostic efficacy indicators(including sensitivity,specificity,accuracy,negative and positive predictive value)of five tumor markers combined detection for lung cancer diagnosis were 94.84%,98.39%,96.61%,95.02%and 98.33%,respectively.Conclusion The combined determination of multiple tumor markers can not only improve the diagnostic accuracy of lung cancer,but also help to understand its pathological types and stages,which could provide reference for the formulation of clinical treatment.