The correlation between combined determination of tumor markers and pathological classification of lung cancer diagnosis

SUN Haibo; SONG Xin; JIN Wei; DONG Zhouhuan; CHEN Wei; GAO Jie

doi:10.3969/j.issn.1007-8096.2025.11.1420

Abstract：Objective This study aims to analyze the diagnostic value of the combined detection of serum carbohydrate antigen 153(CA153),squamous cell carcinoma antigen(SCC),neuron-specific enolase(NSE),and cytokeratin 19 soluble fragment(CYFRA21-1)for lung cancer,as well as the association between these markers and the pathological classification of lung cancer.Methods From January 2019 to August 2021,112 patients with solitary pulmonary nodules in our hospital were enrolled.Fasting serum samples were collected to determine the levels of the above four indicators.Using pathological diagnosis by needle biopsy as the gold standard,the diagnostic efficacy(sensitivity,specificity,accuracy,positive predictive value,negative predictive value)of single-index detection and combined detection were compared.The differences in indicators between patients with lung cancer and benign pulmonary lesions were analyzed,the expression patterns of indicators under different pathological classifications,clinical stages,and lymph node metastasis statuses were explored,and the correlation between marker levels and pathological characteristics of lung cancer was clarified through correlation analysis.Results Among the 112 patients,72 were pathologically diagnosed with lung cancer(25 with small-cell lung cancer and 47 with non-small-cell lung cancer),and 40 with benign nodules;43 were in clinical stage Ⅰ-Ⅱand 29 in stage Ⅲ-Ⅳ;24 had lymph node metastasis and 48 had no metastasis.All indicators of diagnostic efficacy of the combined detection(sensitivity 97.22%,specificity 97.50%,accuracy 97.32%,positive predictive value 98.59%,negative predictive value 95.12%)were superior to those of single-index detection(P<0.05).The levels of the four serum indicators in lung cancer patients were higher than those in patients with benign pulmonary lesions(P<0.05);the indicator levels in patients with small-cell lung cancer were higher than those in patients with non-small-cell lung cancer(P<0.05);the indicator levels in patients with stage Ⅲ-Ⅳ were higher than those in patients with stage Ⅰ-Ⅱ(P<0.05);the indicator levels in patients with lymph node metastasis were higher than those in lung cancer patients without metastasis(P<0.05).Correlation analysis showed that the levels of the four indicators were positively correlated with the pathological classification,clinical stage,and lymph node metastasis of lung cancer(P<0.05).Conclusion The combined detection of CA153,SCC,NSE,and CYFRA21-1 can efficiently diagnose lung cancer,and can assist in distinguishing the pathological classification and clinical stage of lung cancer.Their expression levels are closely related to the pathological characteristics of lung cancer.