Clinical value of dynamic detection of tumor molecular markers in serum in patients with lung cancer

doi:10.3877/cma.j.issn.1674-6902.2019.02.010

Abstract

Abstract:

Objective

To study the clinical value of dynamic detection of serum tumor molecular markers, such as carcinoembryonic antigen tumor molecular markers (CEA), squamous cell carcinoma antigen (Scc Ag) and gastrin-releasing peptide precursor (Pro-GRP31-98), in the early diagnosis and treatment of lung cancer.

Methods

The serum levels of CEA, Scc Ag and Pro-GRP31-98 of 156 patients with lung cancer (lung cancer group), detected by electrochemical luminesence method (ECLIA) and enzyme-linked immunosorbent assay (ELISA), were compared with those of 50 patients with lung benign disease (lung benign group) and 50 people from health checkup (healthy control group) to analyze the clinical value of the three tumor markers in the diagnosis and treatment of lung cancer.

Results

①In the lung cancer group, the levels of CEA, Scc Ag and Pro-GRP31-98 were significantly higher than those of the lung benign group and the healthy control group (P<0.01). However, no significant difference was found between the lung benign group and the healthy control group (P>0.05). ②The levels of serum CEA, Scc Ag and Pro-GRP31-98 in the lung cancer group had no correlation with the gender, age or tumor location (P>0.05), but had close correlations with the tumor size, clinical stage, histological type, recurrence, transfer and treatment (P<0.01). The serum levels of CEA, Scc Ag and Pro-GRP31-98 in the lung cancer high differentiation group (Ⅲ and Ⅳ stages), transfer group, recurrence group, and pre-treatment group were significantly higher than those of the lung cancer low differentiation group (Ⅰ and Ⅱ stages), no metastasis group, no recurrence group, and post-treatment group (P<0.01). ③The serum CEA, Scc Ag and Pro-GRP31-98 had respectively higher positive detection rates of lung adenocarcinoma, squamous cell carcinoma and small cell carcinoma, and had a significant difference with the other two pathological types (P<0.01). ④The sensitivities of serum CEA, Scc Ag and Pro-GRP31-98 in the diagnosis of lung cancer were respectively 51.28%, 48.72% and 50.50%, the specificities were respectively 96.00%, 98.00% and 94.00%, and the accuracies were 62.14%, 60.68% and 62.62%, respectively. The sensitivities of CEA+ Scc-ag, CEA+ Pro-grp31-98, Scc-ag+ Pro-grp31-98 in the diagnosis of lung cancer were respectively 61.54%, 64.74% and 62.18%, the specificities were respectively 92.00%, 90.00% and 92.00%, and the accuracies were 69.27%, 71.22% and 69.76%, respectively. With the combined dynamic detection of the three serum tumor markers in the patients with lung cancer, the sensitivity and accuracy value reached 96.46% and 93.17%, respectively. It also had significant difference compared with single detection and pairwise combination detection (P<0.01).

Conclusion

Tumor markers CEA, scc-Ag and pro-grp31-98 are closely related to the occurrence and development of lung cancer. When they are combined with dynamic detection method, they can complement and reinforce each other, which is conducive to the early diagnosis and early clinical intervention. Dynamic detection can monitor the recurrence and metastasis of tumors, guiding the treatment and evaluating the prognosis.

Key words: Bronchogenic lung cancer, Tumor markers, serology, Combined detection, Clinical application

Ning An, Jiangang Zou, Fengliang Xu. Clinical value of dynamic detection of tumor molecular markers in serum in patients with lung cancer[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2019, 12(02): 181-186.

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组　别	例数	CEA(ng/ml)	Scc-Ag(ng/ml)	Pro-GRP31-98(pg/ml)
肺癌组	156	53.26±19.37^a	33.64±15.79^a	115.36±62.34^a
良性对照组	50	1.89±0.96	0.97±0.23	15.84±3.69
正常对照组	50	1.87±0.89^b	0.95±0.22^b	15.23±3.12^b

组　别	例数	CEA(ng/ml)	Scc-Ag(ng/ml)	Pro-GRP31-98(pg/ml)
肺癌组	156	53.26±19.37^a	33.64±15.79^a	115.36±62.34^a
良性对照组	50	1.89±0.96	0.97±0.23	15.84±3.69
正常对照组	50	1.87±0.89^b	0.95±0.22^b	15.23±3.12^b

临床资料		例数	CEA(ng/ml)	Scc-Ag(ng/ml)	Pro-GRP31-98(pg/ml)
性别		?	?	?	?
?	男	89	54.69±20.06^a	32.26±13.67^a	117.82±63.28^a
?	女	67	52.80±18.76	52.80±16.25	112.71±60.37
年龄(岁)		?	?	?	?
?	≥50	92	53.96±19.67^a	34.27±15.87^a	113.29±61.27^a
?	<50	64	52.25±20.17	30.76±14.27	118.23±63.97
肿瘤部位		?	?	?	?
?	右肺	93	52.25±20.77^a	34.16±16.01^a	114.32±62.09^a
?	左肺	63	55.35±21.45	32.88±15.92	116.89±64.27
肿瘤直径		?	?	?	?
?	≥5 cm	106	62.43±25.14^b	40.12±17.24^b	137.24±69.36^b
?	<5 cm	50	33.82±12.76	27.16±10.17	69.42±32.41
病理组织学		?	?	?	?
?	腺癌	55	86.32±34.27^b	18.64±7.96	87.46±41.92
?	鳞癌	68	33.09±13.67	51.23±20.67^b	83.26±39.67
?	小细胞癌	33	39.41±15.27	23.67±9.25	228.24±92.37^b
临床分期		?	?	?	?
?	Ⅰ＋Ⅱ	67	29.27±10.64	18.73±6.32	57.38±22.37
?	Ⅲ＋Ⅳ	89	71.39±31.67^b	45.27±18.34^b	159.34±71.02^b
区域淋巴结转移		?	?	?	?
?	无	41	13.36±5.12	8.93±3.27	54.36±21.23
?	有	115	67.48±26.34^b	42.37±17.02^b	137.25±68.22^b
远处转移		?	?	?	?
?	无	133	44.33±17.69	23.61±8.64	79.23±32.37
?	有	23	104.49±46.12^b	90.31±32.89^b	326.34±116.34^b
复发		?	?	?	?
?	无	124	20.03±7.24	10.28±2.34	43.51±17.61
?	有	32	181.37±52.43^b	111.37±56.34^b	397.84±125.37^b
治疗		?	?	?	?
?	治疗前	156	53.26±19.37	33.64±15.79	115.36±62.34
?	治疗后	156	11.36±4.62^b	6.72±1.36^b	32.33±8.79^b

临床资料		例数	CEA(ng/ml)	Scc-Ag(ng/ml)	Pro-GRP31-98(pg/ml)
性别		?	?	?	?
?	男	89	54.69±20.06^a	32.26±13.67^a	117.82±63.28^a
?	女	67	52.80±18.76	52.80±16.25	112.71±60.37
年龄(岁)		?	?	?	?
?	≥50	92	53.96±19.67^a	34.27±15.87^a	113.29±61.27^a
?	<50	64	52.25±20.17	30.76±14.27	118.23±63.97
肿瘤部位		?	?	?	?
?	右肺	93	52.25±20.77^a	34.16±16.01^a	114.32±62.09^a
?	左肺	63	55.35±21.45	32.88±15.92	116.89±64.27
肿瘤直径		?	?	?	?
?	≥5 cm	106	62.43±25.14^b	40.12±17.24^b	137.24±69.36^b
?	<5 cm	50	33.82±12.76	27.16±10.17	69.42±32.41
病理组织学		?	?	?	?
?	腺癌	55	86.32±34.27^b	18.64±7.96	87.46±41.92
?	鳞癌	68	33.09±13.67	51.23±20.67^b	83.26±39.67
?	小细胞癌	33	39.41±15.27	23.67±9.25	228.24±92.37^b
临床分期		?	?	?	?
?	Ⅰ＋Ⅱ	67	29.27±10.64	18.73±6.32	57.38±22.37
?	Ⅲ＋Ⅳ	89	71.39±31.67^b	45.27±18.34^b	159.34±71.02^b
区域淋巴结转移		?	?	?	?
?	无	41	13.36±5.12	8.93±3.27	54.36±21.23
?	有	115	67.48±26.34^b	42.37±17.02^b	137.25±68.22^b
远处转移		?	?	?	?
?	无	133	44.33±17.69	23.61±8.64	79.23±32.37
?	有	23	104.49±46.12^b	90.31±32.89^b	326.34±116.34^b
复发		?	?	?	?
?	无	124	20.03±7.24	10.28±2.34	43.51±17.61
?	有	32	181.37±52.43^b	111.37±56.34^b	397.84±125.37^b
治疗		?	?	?	?
?	治疗前	156	53.26±19.37	33.64±15.79	115.36±62.34
?	治疗后	156	11.36±4.62^b	6.72±1.36^b	32.33±8.79^b

检测项目	腺癌(n＝55)	鳞癌(n＝68)	小细胞癌(n＝33)
CEA	37(67.27)^a	18(26.47)	9(27.27)
Scc-Ag	14(25.45)	47(69.12)^a	6(18.18)
Pro-GRP31-98	15(27.27)	16(23.53)	25(75.76)^a

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