Jin Xiangyu, Xu Xiaoling, Xu Haimiao, Lv Lei, Lu Hongyang
Clin Lab. 2017 Apr 1;63(4):801-808. doi: 10.7754/Clin.Lab.2016.160921.
Lung adenosquamous carcinoma (ASC) is a rare malignant tumor with an adenocarcinoma and a squamous cell carcinoma component and associated with a lower 5-year survival rate than lung squamous cell carcinoma and lung adenocarcinoma. Surgical specimen histology revealed the inadequacy of conventional transbronchial needle aspiration samples in the diagnosis of lung ASC. Most lung ASC patients are not suitable to receive surgery, and it is difficult to diagnose ASC. This study is to explore the possibility of using serum carcinoembryonic antigen (CEA) and squamous cell carcinoma antigen (SCC) as a supplementary diagnostic test for ASC.
We retrospectively analyzed the preoperative serum CEA and SCC levels in 34 patients with lung ASC, 35 cases of lung adenocarcinoma patients, 35 cases of lung squamous cell carcinoma patients. 36 cases of lung benign disease patients and 35 cases of healthy people as a control group were also retrospectively collected and analyzed from January 2012 to December 2014 at the Zhejiang Cancer Hospital, China. The differences of CEA and SCC among the groups were evaluated, and the area under the curve (AUC), sensitivity, and specificity were calculated.
The levels of SCC and CEA in the lung ASC group were significantly higher than those in the healthy control group and benign disease group (p < 0.05). The SCC level in lung ASC group was significantly higher than that in lung adenocarcinoma group (p < 0.05). CEA and SCC had good diagnostic sensitivity and specificity compared with the healthy control group, and the difference was statistically significant (p < 0.05).
Our retrospective study suggested a role for serum CEA and SCC levels as reference markers in the diagnosis of lung ASC. Patients with elevated CEA and SCC levels and diagnosed as lung adenocarcinoma by limited biopsy materials should be offered further work-up to reach an accurate diagnosis and treatment.
肺腺鳞癌（ASC）是一种罕见的恶性肿瘤，具有腺癌和鳞癌成分，与肺鳞癌和肺腺癌相比，其5年生存率较低。手术标本组织学显示，传统经支气管针吸活检样本在肺ASC诊断中存在不足。大多数肺ASC患者不适合接受手术，且ASC难以诊断。本研究旨在探讨血清癌胚抗原（CEA）和鳞状细胞癌抗原（SCC）作为ASC辅助诊断检测方法的可能性。
我们回顾性分析了2012年1月至2014年12月在中国浙江省肿瘤医院就诊的34例肺ASC患者、35例肺腺癌患者、35例肺鳞癌患者的术前血清CEA和SCC水平。同时回顾性收集并分析了36例肺良性疾病患者和35例健康人的数据作为对照组。评估各组间CEA和SCC的差异，并计算曲线下面积（AUC）、敏感性和特异性。
肺ASC组的SCC和CEA水平显著高于健康对照组和良性疾病组（p < 0.05）。肺ASC组的SCC水平显著高于肺腺癌组（p < 0.05）。与健康对照组相比，CEA和SCC具有良好的诊断敏感性和特异性，差异有统计学意义（p < 0.05）。
我们的回顾性研究表明，血清CEA和SCC水平可作为肺ASC诊断的参考指标。对于CEA和SCC水平升高且经有限活检材料诊断为肺腺癌的患者，应进一步检查以明确准确诊断和治疗。
