The relationship between lung function and tumor marker levels in patients with lung cancer complicated with chronic obstructive pulmonary disease

WANG Huifang; JIANG Yalin; QU Xiangkun; QIAN Hui

doi:10.3969/j.issn.1674-4136.2024.04.013

Abstract：Objective Objective To investigate the relationship between five tumor markers(CYFRA21-1,CEA,CA125,CA153,CA199),vascular endothelial growth factor(VEGF)levels and lung function and prognosis in patients with chronic obstructive pulmonary disease(COPD)complicated with lung cancer.Methods A total of 90 COPD patients with lung cancer who were treated in Bozhou People's Hospital from January 2021 to June 2022 were selected as the observation group,and 50 healthy people who underwent physical examination in Bozhou People's Hospital during the same period were selected as the control group.The lung function indexes,five tumor markers and VEGF levels were compared between the two groups.Pearson correlation analysis was used to analyze the correlation between pulmonary function indexes,five tumor markers and VEGF in the observation group.According to the prognosis of the observation group,the patients were divided into a good prognosis group and a poor prognosis group,and the clinical data,five tumor markers and VEGF levels of the two groups were compared.Logistic regression analysis was used to analyze the effect of multiple factors on the prognosis of COPD patients with lung cancer.ROC curve was used to analyze the value of five tumor markers and VEGF in predicting the prognosis of COPD patients with lung cancer.Results The levels of forced vital capacity(FVC),forced expiratory volume in the first second(FEV1)and FEV1 percentage of predicted value(FEV1%pred)in the observation group were significantly lower than those in the control group.The levels of serum CYFRA21-1,CEA,CA125,CA153,CA199 and VEGF were significantly higher than those in the control group(P＜0.05).Pearson correlation results showed that FVC,FEV1,FEV1%pred of COPD patients with lung cancer were negatively correlated with serum CYFRA21-1,CEA,CA125,CA153,CA199 and VEGF(P＜0.05).There were significant differences in TNM stage,degree of differentiation,lymph node metastasis,FVC,FEV1,FEV1%pred,CYFRA21-1,CEA,CA125,CA153,CA199,VEGF and other data between the good prognosis group and the poor prognosis group(P＜0.05).Logistic multivariate regression analysis showed that,the progression of TNM stage,increased degree of differentiation,lymph node metastasis,decreased FVC,FEV1,FEV1%pred,increased CYFRA21-1,increased CEA,increased CA125,increased CA153,increased CA199,and increased VEGF were risk factors for poor prognosis.ROC curve results showed that the area under the curve of CYFRA21-1,CEA,CA125,CA153,CA199,and VEGF was 0.678,0.765,0.852,0.867,0.869,and 0.835 respectively.The area under the curve of combined detection was 0.927(P＜0.05),indicating that combined detection could be used as an effective monitoring indicator to evaluate the prognosis of patients with COPD complicated with lung cancer.Conclusions The levels of serum CYFRA21-1,CEA,CA125,CA153,CA199 and VEGF in COPD patients with lung cancer are negatively correlated with their pulmonary function indexes,and the combined detection can be used as an effective monitoring index to evaluate the prognosis of patients,which is worthy of clinical application.