RESUMEN
Objective:To investigate the clinical values of progastrin-releasing peptide (Pro-GRP), neuron-specific enolase (NSE), cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), squamous cell carcinoma antigen (SCCA) and human human epididymis protein 4 (HE4) detections in the diagnosis of lung cancer patients.Methods:The clinical data of 200 lung cancer patients who were admitted to the Second Affiliated Hospital of Xuzhou Medical University from January 2020 to December 2021 were retrospectively analyzed. According to the pathological type, the patients were divided into lung adenocarcinoma group (80 cases), lung squamous cell carcinoma group (75 cases) and small cell lung cancer group (45 cases). Fifty patients with benign lung diseases and 50 healthy physical examiners who were admitted to the hospital during the same period were selected. All the subjects were tested for the levels of Pro-GRP, NSE, CYFRA21-1, SCCA and HE4, and the differences of each index level in the subjects of different subgroups were compared. The receiver operating characteristic (ROC) curve was drawn, and using pathological diagnosis result as the gold standard, the diagnostic efficacy of each index alone and in combination for lung cancer was compared.Results:The serum levels of Pro-GRP, NSE, CYFRA21-1, SCCA and HE4 in lung cancer group were higher than those in the benign lung diseases group and the healthy control group (all P < 0.001). There were no statistical differences in the levels of serum Pro-GRP, NSE, CYFRA21-1, SCCA and HE4 between the benign lung diseases group and the healthy control group (all P > 0.05). The levels of Pro-GRP, NSE and HE4 in the small cell lung cancer group were higher than those in the lung adenocarcinoma group and the lung squamous cell carcinoma group (all P < 0.05). NSE and HE4 levels in the lung adenocarcinoma group were higher than those in the lung squamous carcinoma group (both P < 0.05), while CYFRA21-1 and SCCA levels were lower than those in the lung squamous carcinoma group (both P < 0.05). The AUC of lung cancer diagnosed by HE4 was the largest (0.813), the AUC of lung adenocarcinoma diagnosed by HE4 was the largest (0.824), the AUC of lung squamous carcinoma diagnosed by CYFRA21-1 was the largest (0.884), and the AUC of small cell lung cancer diagnosed by NSE was the largest (0.959). The AUC of lung cancer diagnosed by combined detection of 5 indicators was 0.951, the AUC of lung adenocarcinoma and small cell lung cancer diagnosed by combined detection of 5 indicators was 0.975 and 0.996, and the AUC of lung squamous cell carcinoma diagnosed by combined detection of CYFRA21-1, SCCA and HE4 was 0.967. Conclusions:The levels of Pro-GRP, NSE, CYFRA21-1, SCCA, HE4 and other indicators have certain clinical values in the diagnosis of lung cancer and its pathological types, and the combined detection of each index is more valuable than a single index.
RESUMEN
Objective To investigate the clinical value of serum ferritin (SF) combined with 4 tumor mark-ers in the early diagnosis of lung cancer in elderly patients .Methods 185 cases of elderly patients with early-stage lung cancer as lung cancer group ,60 cases of elderly patients with benign lung disease as benign lung disease group ,50 healthy people were enrolled as healthy control group ,compared three groups of subjects of serum SF ,carbohydrate antigen 125 (CA125 ) ,carcinoembryonic antigen (CEA ) ,neuron-specific enolase (NSE) ,cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) expression and sensitivity ,specificity ,ROC curve analysis of the diagnostic index value .Results CA125 ,SF ,CEA ,NSE and CYFRA21-1 in lung cancer group , were higher than those of benign lung disease group and healthy control group ,the difference was statistically significant (P＜0 .05) ;SF ,CA125 ,CEA ,NSE and CYFRA21-1 of the benign lung disease group and healthy control group ,which showed no difference (P＞0 .05) .SF and NSE were the highest in patients with small cell lung cancer ,the difference was statistically significant (P＜0 .05) ,CA125 and CEA were the highest in adeno-carcinoma patients ,the difference was statistically significant (P＜0 .05) ,and CYFRA21-1 was the highest in squamous cell carcinoma patients ,the difference was statistically significant (P＜0 .05) .Compared with the single diagnosis of each index ,the sensitivity of combined detection of the five indicators increased ,the differ-ence was statistically significant (P＜0 .05) ,while the specificity did not change ,the difference was not statis-tically significant(P＞0 .05) .The area under the ROC curve of SF ,CA125 ,CEA ,NSE and CYFRA21-1 was 0 .808 ,0 .762 ,0 .761 ,0 .712 and 0 .781 ,respectively .The area under the ROC curve of the 5 indexes was 0 .915 . Conclusion Serum ferritin combined with 4 tumor markers can improve the diagnostic sensitivity of early eld-erly patients with lung cancer ,and effectively improve the diagnostic value of patients ,thereby contributing to the improvement of the clinical prognosis of patients .
RESUMEN
Objective To investigate expression of cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) and squamous cell carcinoma antigen (SCC-Ag) in cervical cancer patients with lung metastasis before treatment and their prognostic value. Methods The pretreatment serum expression levels of SCC-Ag and CYFRA21-1 of 72 cervical cancer patients with lung metastasis were measured. Survival rate analysis and Cox proportional hazard model were performed to evaluate the prognostic significance of two pretreatment variables. Results The media survival time (MST) of 72 patients was 14 months, and 38 (52.8 %) patients with pulmonary metastasis occurred in 1 year of treatment. The pretreatment serum SCC-Ag and CYFRA21-1 levels in the patients with tumor diameter over 4 cm or with squamous cell carcinoma were higher than those in the other patients (all P3.3 mg/L) was higher than that in the negative group (13 months vs 19 months, P1.5 mg/L) was also higher than that in the negative group (14 months vs 21 months, P<0.05). The result of Cox regression analysis showed that the tumor diameter (OR = 11.6, P = 0.01), pretreatment serum SCC-Ag (OR= 4.2, P= 0.01) and CYFRA21-1 (OR= 8.2, P= 0.05) levels were independent prognostic factors of overall survival. Conclusion Pretreatment CYFRA 21-1 and SCC-Ag levels may be considered as useful prognostic indicators for cervical cancer patients with lung metastasis.
RESUMEN
Objective The aim of this study was to assess the clinical value of pro-gastrin releasing peptide (ProGRP) , squamous cell carcinoma antigen (SCC-Ag), cytokeratin 19 fragment antigen 21-1 (Cyfra21-1) and carcino-embryonic antigen (CEA) in the diagnosis and clinical stage of lung cancer in Chinese patients.Methods Patients with lung cancer and benign lesions confirmed by pathology were enrolled in Peking Union Medical College Hospital from January 2013 to October 2014.The serum levels of four tumor markers (ProGRP, SCC-Ag, Cyfra21-1 and CEA) were measured using immunoassays before treatment.The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and the areas under the receiver operating characteristic curve (AUCROC) of these four tumor biomarkers were analyzed for the diagnosis of lung cancer.Results A total of 134 patients were finally analyzed, including 73 patients with lung cancer and the other 61 patients with benign lung disease.The diagnostic sensitivity of serum Cyfra21-1 to lung cancer was 67.1％, the specificity 45.1％, the AUCROC 0.658.The diagnostic sensitivity of the panel including ProGPR, Cyfra21-1 and CEA to lung cancer was 75.3％ , the specificity 57.4％ , the AUCROC 0.702.In the lung cancer group, the AUCROC of ProGRP over 65 ng/L to diagnose small cell lung cancer was 0.954;the AUCROC of SCC-Ag over 1.5 μg/L to diagnose squamous cell lung cancer was 0.788;the AUCROC of Cyfra21-1 to diagnose non-squamous-non-small-cell lung cancer was 0.716.In small cell lung cancer patients, the level of ProGRP in limited-disease small cell lung cancer (LD-SCLC) were significantly higher than that in extensive-disease small cell lung cancer (ED-SCLC) (P =0.005).Conclusion This panel of serum tumor markers including ProGRP, Cyfra21-1 and CEA improves the diagnostic specificity and sensitivity in patients with high-risk lung cancer.The serum CEA level of advanced lung cancer patients is significantly increased.The high level of serum ProGRP predicts the ED-SCLC.