Utility of squamous cell carcinoma antigen, carcinoembryonic antigen, Cyfra 21-1 and neuron specific enolase in lung cancer diagnosis： a prospective study from China

作     者：SONG Wei-an LIU Xi TIAN Xiao-dong WANG Wei LIANG Chao-yang ZHANG Tao GUO Jun-tang PENG Yang-hong ZHOU Nai-kang 

作者机构：Department of Thoracic Surgery Chinese People＇s Liberation Army General Hospital Beijing 100853 China Department of Thoracic Surgery Navy General Hospital Beijing 100037 China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2011年第124卷第20期

页      面：3244-3248页

核心收录：

学科分类：090603[农学-临床兽医学] 0710[理学-生物学] 1002[医学-临床医学] 07[理学] 09[农学] 0906[农学-兽医学] 071006[理学-神经生物学] 

主　　题：lung neoplasm tumor marker diagnosis 

摘      要：Background Early detection and diagnosis is urgent for the sake of effective treatment strategy for lung cancer. However, a convenient, economical and relatively precise method is not available. We here report a prospective study to find the possible value of the combined use of four popular tumor markers in the early diagnosis of lung cancer among patients with suspicious nodules in the lung. Methods Six hundred and sixty inpatients with suspicious nodules in the lung were divided into a lung cancer group and a benign pulmonary tumor group according to post-operative histological examinations. Serum levels of four tumor markers including squamous cell carcinoma antigen （SCC）, carcinoembryonic antigen （CEA）, Cyfra 21-1 and neuron specific enolase （NSE） were assayed for each patient. Receiver operating characteristic （ROC） curves were constructed for each tumor marker. The power of lung cancer diagnosis of each tumor marker, as well as a combination of them were analyzed and compared. Results The serum levels （median, range） of SCC, CEA, Cyfra 21-1 and NSE were 0.44 （0.01-35.70） ng/ml, 2.49 （0.30-26.78） ng/ml, 2.30 （0.82-73.33） ng/ml and 10.54 （0.10-56.41） ng/ml respectively in lung cancer group, and were 0.32 （0.01-0.90） ng/ml, 1.60 （0.20-8.93） ng/ml, 1.41 （0.72-4.82） ng/ml and 9.36 （6.56-24.24） ng/ml respectively in the benign pulmonary tumor group. The difference in each tumor marker between the two groups was significant （P 〈0.05）. The ROCs of SCC, CEA, Cyfra 21-1 and NSE were 0.702 （95% CI, 0.654-0.751）, 0.611 （95% CI, 0.563-0.659）, 0.650 （95% Cl, 0.601-0.700） and 0.598 （95% Cl, 0.542-0.654） respectively, indicating very low power of these four tumor markers. When a combination of SCC, CEA, Cyfra 21-1 and NSE were empfoyed, the diagnosis power was strengthened. Conclusion SCC, CEA, Cyfra 21-1 and NSE are valuable in the early diagnosis of lung cancer among suspicious nodules in the lung, especially when they were assayed together for one patient.