To evaluate the predictive value of combined five tumor markers (TMs) CEA, NSE, SCCA, CYFRA21-1 and ProGRP in the diagnosis of lung cancer(LC). Total of 305 hospitalized patients with LC were enrolled, 100 healthy subjects and 100 patients with benign lung diseases were selected as the healthy control (HC) group and BLD group, respectively. The levels of TMs in serum were detected by Flow fluorescence technique. Positivity rates were analyzed by using Chi-square test,The differences of tumor marker levels were compared using Mann-Whitney test and Kruskal-Wallis test. The Receiver Operating Characteristics (ROC) curve was performed to analyze the diagnosis efficacy of TMs. The combined detection had a higher positive rate in patients with LC, adenoadenocarcinoma, squamous cell carcinoma and SCLC (70.82%, 64.74%, 76.4% and 81.03%, respectively) than each TM considered individually. The serological levels of CEA, NSE, SCCA, CYFRA21-1 in LC group were higher than HC and BLD group. The differences of them among the three groups were statistically significant (χ²=90.599, 32.802, 8.473, 40.397 respectively, all P values were<0.05), ProGRP level had no remarkable difference (χ²=3.366, P>0.05), whereas ProGRP level in SCLC were significantly higher compared with adenocarcinoma (Z=6.404,P<0.001) and squamous cell carcinoma (Z=5.765,P<0.001) group. The combined detection difference of positive rate between the early stages(stageⅠ and stage Ⅱ)and the advanced stages (stage Ⅲ and stage Ⅳ) were statistically significant(χ²=24.941, P<0.001).The positive rate of combined detection in the diagnosis of lung cancer lymph node metastasis(76.31%) or distant metastasis(78.18%) was significantly higher than that of single detection. Meanwhile, the positive rate of combined detection in patients with lymph node metastasis or distant metastasis was significantly higher than that in patients without metastasis(χ²=24.60, 9.50 respectively, all P values were<0.05).The combined detection had a better sensitivity(70.82%), accuracy(69.10%)and negative predictive value (59.91%)in LC group than each TM considered individually.The ROC curve showed that the AUC of combined detection in the diagnosis of LC, lung adenocarcinoma, lung squamous cell carcinoma and SCLC were 0.769, 0.780, 0.766 and 0.831, respectively.The combined detection of five tumor markers of CEA, NSE, SCCA, CYFRA21-1 and ProGRP by flow fluorescence technique can improve the diagnostic efficiency of lung cancer.
旨在探讨流式荧光发光法联合检测血清学肿瘤标志物癌胚抗原（CEA）、神经元特异性烯醇化酶（NSE）、鳞状上皮细胞癌抗原（SCCA）、细胞角蛋白片段19（CYFRA21-1）和胃泌素释放肽前体（ProGRP）水平在肺癌辅助诊断中的预测价值，采用病例对照研究设计，本研究收集2019年12月至2020年3月广州医科大学附属第一医院诊断为肺癌的住院患者305例（其中腺癌156例、鳞癌89例、小细胞肺癌58例、大细胞肺癌2例）为肺癌组，同时选择体检健康对照组（HC）和肺部良性疾病对照组（BLD）各100例，应用流式荧光发光法检测血清中肿瘤标志物的水平。阳性率比较采用卡方检验，肿瘤标志物水平比较采用Mann-Whitney和Kruskal-Wallis检验，并绘制受试者工作特征（ROC）曲线，分析各标志物单项及联合检测在肺癌及其病理分型诊断中的应用价值。血清中五项肿瘤标志物联合检测辅助诊断肺癌、肺腺癌、肺鳞癌、小细胞肺癌的阳性率分别为：70.82%、64.74%、76.40%、81.03%，均显著高于单项检测。CEA、NSE、SCCA和CYFRA21-1水平在肺癌组、HC组和BLD组间比较（χ²值分别为90.599、32.802、8.473、40.397，P均<0.05）差异具有统计学意义；ProGRP水平在这三组间的差异无统计学意义（χ²值为3.366，P>0.05），但在小细胞肺癌与肺腺癌（Z=6.404，P<0.001）和肺鳞癌（Z=5.765，P<0.001）组间的差异有统计学意义。血清中五项肿瘤标志物联合检测可以提高早期（Ⅰ+Ⅱ）和晚期（Ⅲ+Ⅳ）患者诊断的阳性率，晚期患者的阳性率（76.34%）与早期（35.29%）比较差异有统计学意义（χ²=24.941， P<0.001）。血清中五项肿瘤标志物联合检测诊断肺癌淋巴结转移阳性检出率（76.31%）和远端转移的阳性检出率（78.18%）均显著高于单项检测，同时在淋巴结转移患者和远端转移患者的阳性检出率明显高于未转移患者（χ²值分别为24.60、9.50，P均<0.05）。血清中五项肿瘤标志物联合检测诊断肺癌的灵敏度（70.82%）、准确度（69.10%）、阴性预测值（59.91%）均高于单项检测，ROC曲线显示，血清中五项肿瘤标志物联合检测诊断肺癌、肺腺癌、肺鳞癌、小细胞肺癌的AUC分别为0.769、0.780、0.766和0.831。流式荧光发光法联合检测CEA、NSE、SCCA、CYFRA21-1和ProGRP五项肿瘤标志物可提高肺癌及其不同病理类型的诊断效能。.