Gao J, Zhang L, Peng K, Sun H
Clinical Laboratory, First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2022 Jun 20;42(6):886-891. doi: 10.12122/j.issn.1673-4254.2022.06.12.
To evaluate the diagnostic value of the serum tumor markers carcinoembryonic antigen (CEA), cytokeratin-19-fragment (CYFRA21-1), squamous cell carcinoma associated antigen (SCCAg), neuron-specificenolase (NSE) and pro-gastrin-releasing peptide (ProGRP) for lung cancers of different pathological types.
This study was conducted among patients with established diagnoses of lung adenocarcinoma (LADC, =137), lung squamous cell carcinoma (LSCC, =82), small cell lung carcinoma (SCLC, =59), and benign chest disease (BCD, =102). The serum tumor markers were detected for all the patients for comparison of the positivity rates and their serum levels. ROC curve was used for analysis of the diagnostic efficacy of these tumor markers either alone or in different combinations.
In patients with LADC, the positivity rate and serum level of CEA were significantly higher than those in the other groups ( < 0.05); the patients with LSCC had the highest positivity rate and serum level of SCCAg among the 4 groups ( < 0.05). The positivity rates and serum levels of ProGRP and NSE were significantly higher in SCLC group than in the other groups ( < 0.05). CYFRA21-1 showed the highest positivity rate and serum level in LADC group and LSCC group. With the patients with BCD as control, CEA showed a diagnostic sensitivity of 62.8% and a specificity of 93.1% for LADC, and the sensitivity and specificity of SCCAg for diagnosing LSCC were 64.6% and 91.2%, respectively. CYFRA21-1 had the highest diagnostic sensitivity for LADC and LSCC. The diagnostic sensitivity and specificity of ProGRP for SCLC were 83.1% and 98.0%, respectively. When combined, CYFRA21-1 and CEA showed a high sensitivity (78.8%) and specificity (86.3%) for diagnosing LADC with an AUC of 0.891; CYFRA21-1 and SCCAg had a high sensitivity (84.1%) and specificity (87.3%) for diagnosing LSCC with an AUC of 0.912. NSE combined with ProGRP was highly sensitive (88.1%) and specific (98.0%) for diagnosis of SCLC, with an AUC of 0.952. For lung cancers of different pathological types, the combination of all the 5 tumor markers showed no significant differences in the diagnostic power from a combined detection with any two of the markers (>0.05).
CEA, CYFRA21-1, SCCAg, NSE and ProGRP are all related to the pathological type of lung cancers and can be used in different combinations as useful diagnostic indicators for lung cancers.
评估血清肿瘤标志物癌胚抗原（CEA）、细胞角蛋白19片段（CYFRA21-1）、鳞状细胞癌相关抗原（SCCAg）、神经元特异性烯醇化酶（NSE）和胃泌素释放肽前体（ProGRP）对不同病理类型肺癌的诊断价值。
本研究纳入已确诊为肺腺癌（LADC，n = 137）、肺鳞状细胞癌（LSCC，n = 82）、小细胞肺癌（SCLC，n = 59）和良性胸部疾病（BCD，n = 102）的患者。检测所有患者的血清肿瘤标志物，比较其阳性率及血清水平。采用ROC曲线分析这些肿瘤标志物单独及不同组合的诊断效能。
LADC患者中，CEA的阳性率和血清水平显著高于其他组（P < 0.05）；LSCC患者的SCCAg阳性率和血清水平在四组中最高（P < 0.05）。SCLC组中ProGRP和NSE的阳性率及血清水平显著高于其他组（P < 0.05）。CYFRA21-1在LADC组和LSCC组中的阳性率及血清水平最高。以BCD患者为对照，CEA对LADC的诊断敏感性为62.8%，特异性为93.1%，SCCAg诊断LSCC的敏感性和特异性分别为64.6%和91.2%。CYFRA21-1对LADC和LSCC的诊断敏感性最高。ProGRP对SCLC的诊断敏感性和特异性分别为83.1%和98.0%。联合检测时，CYFRA21-1和CEA诊断LADC的敏感性高（78.8%）、特异性高（86.3%），AUC为0.891；CYFRA21-1和SCCAg诊断LSCC的敏感性高（84.1%）、特异性高（87.3%），AUC为0.912。NSE与ProGRP联合诊断SCLC的敏感性高（88.1%）、特异性高（98.0%），AUC为0.952。对于不同病理类型的肺癌，5种肿瘤标志物联合检测与任意两种标志物联合检测的诊断效能无显著差异（P > 0.05）。
CEA、CYFRA21-1、SCCAg、NSE和ProGRP均与肺癌的病理类型相关，可不同组合用于肺癌的有效诊断指标。
