Chen Feng, Li Jia, Qi Xin, Qi Jun
Department of Clinical Laboratory, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, P.R, China.
Department of Clinical Laboratory, China-Japan Union Hospital of Jilin University, Changchun 130031, Jilin, P.R. China.
J Cancer Res Ther. 2018 Jun;14(Supplement):S400-S404. doi: 10.4103/0973-1482.174180.
Lung cancer is sometimes difficult to differentiate from benign lung diseases with nodular shadow in imaging scan. In these cases, exploratory operation is needed for the patients with highly suspected malignant disease. Therefore, there is an urgent demand to differentiate the benign lung disease from malignant lung nodules rather than invasive method.
We evaluated the diagnostic value of two tumor markers in distinguishing operable lung cancer from benign lung disease.
The serum levels of carcinoembryonic antigen (CEA) and CYFRA 21-1 were retrospectively analyzed in 236 lung cancer patients and 44 patients with benign lung disease. These benign lung diseases were presented with evidence of a high likelihood of having lung cancer. After surgical operation, diagnosis of lung cancer and benign lung disease were confirmed by histological examination.
We found that the average level of tumor marker in operable lung cancer patients was higher than those in patients with benign lung disease. CYFRA 21-1 sensitivity and specificity for lung cancer diagnosis was 37.3% and 90.9%, respectively, while that for CEA was 22.0% and 90.9%. The combined value for the sensitivity and specificity of these two tumor markers was 47.5% and 81.8%, respectively.
Our results indicate that the combination of these two tumor markers resulted in higher sensitivity compared to use CYFRA 21-1 or CEA along. Given its lower sensitivity and higher specificity, positive CYFRA 21-1 or positive CEA strongly supports lung cancer in patients with nodular shadow in imaging scan.
肺癌在影像学扫描中有时难以与具有结节状阴影的良性肺部疾病相区分。在这些情况下，对于高度怀疑为恶性疾病的患者需要进行 exploratory 手术。因此，迫切需要采用非侵入性方法将良性肺部疾病与恶性肺结节区分开来。
我们评估了两种肿瘤标志物在区分可手术肺癌与良性肺部疾病方面的诊断价值。
回顾性分析了 236 例肺癌患者和 44 例良性肺部疾病患者的血清癌胚抗原（CEA）和细胞角蛋白 19 片段（CYFRA 21-1）水平。这些良性肺部疾病具有高度疑似肺癌的证据。手术后，通过组织学检查确诊肺癌和良性肺部疾病。
我们发现可手术肺癌患者的肿瘤标志物平均水平高于良性肺部疾病患者。CYFRA 21-1 对肺癌诊断的敏感性和特异性分别为 37.3%和 90.9%，而 CEA 分别为 22.0%和 90.9%。这两种肿瘤标志物联合检测的敏感性和特异性分别为 47.5%和 81.8%。
我们的结果表明，与单独使用 CYFRA 21-1 或 CEA 相比，这两种肿瘤标志物联合检测具有更高的敏感性。鉴于其较低的敏感性和较高的特异性，CYFRA 21-1 阳性或 CEA 阳性强烈支持影像学扫描有结节状阴影的患者患有肺癌。
