Liu Linjie, Teng Jinlong, Zhang Lijun, Cong Peishan, Yao Yuan, Sun Guirong, Liu Zhijun, Yu Teng, Liu Mingjun
Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao 266003, China.
Department of Critical Care Medicine, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao 266003, China.
Biomed Res Int. 2017;2017:2013989. doi: 10.1155/2017/2013989. Epub 2017 May 18.
Tumor markers are beneficial for the diagnosis and therapy monitoring of lung cancer. However, the value of tumor markers in lung cancer histological diagnosis is unknown. In this study, we analyzed the serum levels of six tumor markers (CEA, CYFRA21-1, SCC, NSE, ProGRP, and CA125) in 2097 suspected patients with lung cancer and determined whether the combination of the tumor markers was useful for histological diagnosis of lung cancer. We found that CYFRA21-1 was the most sensitive marker in NSCLC. ProGRP showed a better clinical performance than that of NSE in discriminating between SCLC and NSCLC. The serum level of CYFRA21-1 or SCC was significantly higher in squamous carcinoma ( < 0.05), and the levels of ProGRP and NSE were significantly higher in SCLC ( < 0.05). According to the criteria established, SCLC and NSCLC were discriminated with sensitivity of 87.12 and 62.63% and specificity of 64.61 and 99.5%, respectively. The sensitivity and specificity in the differentiation of adenocarcinoma and squamous carcinoma were 68.1 and 81.63% and 70.73 and 65.93%, with NPV of 46.03 and 68.97% and PPV of 85.82 and 79.47%, respectively. Our results suggested the combination of six tumor markers could discriminate the histological types of lung cancer.
肿瘤标志物有助于肺癌的诊断和治疗监测。然而,肿瘤标志物在肺癌组织学诊断中的价值尚不清楚。在本研究中,我们分析了2097例疑似肺癌患者血清中六种肿瘤标志物(癌胚抗原、细胞角蛋白19片段、鳞状细胞癌抗原、神经元特异性烯醇化酶、胃泌素释放肽前体和癌抗原125)的水平,并确定这些肿瘤标志物的组合是否有助于肺癌的组织学诊断。我们发现,细胞角蛋白19片段是在非小细胞肺癌中最敏感的标志物。在鉴别小细胞肺癌和非小细胞肺癌方面,胃泌素释放肽前体比神经元特异性烯醇化酶表现出更好的临床性能。鳞状细胞癌患者血清中细胞角蛋白19片段或鳞状细胞癌抗原水平显著更高(P<0.05),小细胞肺癌患者血清中胃泌素释放肽前体和神经元特异性烯醇化酶水平显著更高(P<0.05)。根据既定标准,鉴别小细胞肺癌和非小细胞肺癌的灵敏度分别为87.12%和62.63%,特异性分别为64.61%和99.5%。鉴别腺癌和鳞状细胞癌的灵敏度和特异性分别为68.1%和81.63%以及70.73%和65.93%,阴性预测值分别为46.03%和68.97%,阳性预测值分别为85.82%和79.47%。我们的结果表明,六种肿瘤标志物的组合可鉴别肺癌的组织学类型。