Xu Shihao, Hu Tianqi, Zhou Chenkang, Wang Min, Jiang Jiachun, Wang Yumin, Wang Caihong
Department of Ultrasound, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Laboratory Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
J Thorac Dis. 2024 Sep 30;16(9):5709-5717. doi: 10.21037/jtd-24-410. Epub 2024 Sep 20.
Lymph node metastasis (LNM) plays an important role in prognosis of lung cancer, either in preoperative TNM staging or postoperative disease recurrence or progress. This study aimed to explore the diagnostic performances of biomarkers from lymph node eluate for LNM in lung adenocarcinoma (LUAD).
A prospective analysis was conducted based on lymph node eluate specimens collected via ultrasound-guided lymph node biopsy from 48 LUAD patients with suspected LNM in the neck. According to cytopathological results, the patients were categorized into two groups: one with LNM and the other with non-LNM (NLNM). Carcinoembryonic antigen (CEA), cytokeratin 21-1 fragment (CYFRA21-1), neuron-specific enolase (NSE) and gastrin precursor releasing peptide (ProGRP) in lymph node eluate were detected by immunoassay analyzers, and tumor marker was simultaneously collected in serum of patients.
The serum levels of CEA, CYFRA21-1, NSE, and the ratios of CYFRA21-1 and NSE in the lymph node eluate to serum were significantly higher in the LNM group, compared to NLNM group. The areas under curves (AUCs) for CEA, CYFRA21-1, NSE, and ratios of CYFRA21-1 and NSE were 0.79, 0.91, 0.85, 0.93, and 0.89, respectively. The ratio of CYFRA21-1 in lymph node eluate to serum (rCYFRA21-1) performed best in diagnosing, with a sensitivity of 92.3%, a specificity of 92.9%, and an AUC of 0.93.
The rCYFRA21-1 to that in the serum might serve as a potential predictor for LNM in LUAD.
淋巴结转移（LNM）在肺癌预后中起着重要作用，无论是在术前TNM分期还是术后疾病复发或进展方面。本研究旨在探讨来自淋巴结洗脱液的生物标志物对肺腺癌（LUAD）中LNM的诊断效能。
对48例疑似颈部LNM的LUAD患者经超声引导下淋巴结活检收集的淋巴结洗脱液标本进行前瞻性分析。根据细胞病理学结果，将患者分为两组：一组为LNM组，另一组为非LNM（NLNM）组。采用免疫分析仪器检测淋巴结洗脱液中的癌胚抗原（CEA）、细胞角蛋白21-1片段（CYFRA21-1）、神经元特异性烯醇化酶（NSE）和胃泌素释放肽前体（ProGRP），并同时收集患者血清中的肿瘤标志物。
与NLNM组相比，LNM组血清CEA、CYFRA21-1、NSE水平以及淋巴结洗脱液中CYFRA21-1和NSE与血清的比值显著更高。CEA、CYFRA21-1、NSE以及CYFRA21-1和NSE比值的曲线下面积（AUC）分别为0.79、0.91、0.85、0.93和0.89。淋巴结洗脱液中CYFRA21-1与血清的比值（rCYFRA21-1）在诊断中表现最佳，敏感性为92.3%，特异性为92.9%，AUC为0.93。
淋巴结洗脱液中CYFRA21-1与血清中CYFRA21-1的比值可能作为LUAD中LNM的潜在预测指标。
