Wu Heming, Wang Qiuming, Liu Qinghua, Zhang Qunji, Huang Qingyan, Yu Zhikang
Clin Lab. 2020 Mar 1;66(3). doi: 10.7754/Clin.Lab.2019.190533.
To explore the clinical value of combined detection of serum tumor markers in lung cancer, including carcinoembryonic antigen (CEA), carbohydrate antigen 15-3 (CA15-3), cytokeratin 19 fragment (CYFRA 21-1), neuron specific enolase (NSE), and squamous carcinoma antigen (SCCA).
The expression levels were compared among groups, and the combined effects of these tumor markers in the diagnosis of lung cancer were analyzed. In addition, EGFR gene mutations were detected in some patients with NSCLC.
There were 776 patients (age 59.78 ± 10.39 years) with lung cancer and 794 controls (age 58.26 ± 15.73 years) included in our study. In this study, tumor markers were detected in lung cancer patients and controls. Individual sensitivity of the tumor markers sorted in descending order were CEA > CYFRA21-1 > CA15-3 > NSE, and the specificities were NSE > CYFRA21-1 > CEA > CA15-3. The combination of CEA + CA15-3 + CYFRA21-1 + NSE ranked the highest in the sensitivity index (75.00%) and specificity index (98.61%) in lung cancer. In adenocarcinoma, the area under the ROC curve (AUROC) of CEA (0.665) and CYFRA21-1 (0.631) were higher than those of CA15-3 (0.559) and NSE (0.507). In squamous carcinoma, the AUC of CYFRA21-1 (0.722) and SCC (0.628) were higher than those of CEA (0.579), CA15-3 (0.524), and NSE (0.552). In small cell carcinoma, the AUC of NSE (0.654) was higher than those of CEA (0.616), CYFRA21-1 (0.555), and CA15-3 (0.482).
These serum tumor markers are valuable indicators in the clinical use. The combination of tumor markers can be used as a method to improve the effectiveness of clinical diagnosis for lung cancer.
探讨联合检测血清肿瘤标志物癌胚抗原（CEA）、糖类抗原15-3（CA15-3）、细胞角蛋白19片段（CYFRA 21-1）、神经元特异性烯醇化酶（NSE）和鳞状细胞癌抗原（SCCA）在肺癌中的临床价值。
比较各组间的表达水平，并分析这些肿瘤标志物在肺癌诊断中的联合作用。此外，对部分非小细胞肺癌患者检测表皮生长因子受体（EGFR）基因突变。
本研究纳入776例肺癌患者（年龄59.78±10.39岁）和794例对照者（年龄58.26±15.73岁）。在本研究中，对肺癌患者和对照者进行肿瘤标志物检测。肿瘤标志物的单项敏感度由高到低依次为CEA＞CYFRA21-1＞CA15-3＞NSE，特异度依次为NSE＞CYFRA21-1＞CEA＞CA15-3。CEA+CA15-3+CYFRA21-1+NSE联合检测在肺癌中的敏感度指数（75.00%）和特异度指数（98.61%）最高。在腺癌中，CEA（0.665）和CYFRA21-1（0.631）的ROC曲线下面积（AUROC）高于CA15-3（0.559）和NSE（0.507）。在鳞癌中，CYFRA21-1（0.722）和SCC（0.628）的AUC高于CEA（0.579）、CA15-3（0.524）和NSE（0.552）。在小细胞肺癌中，NSE（0.654）的AUC高于CEA（0.616）、CYFRA21-1（0.555）和CA15-3（0.482）。
这些血清肿瘤标志物是临床应用中有价值的指标。联合检测肿瘤标志物可作为提高肺癌临床诊断效能的一种方法。
