Diagnostic utility of CYFRA 21-1, carcinoembryonic antigen, CA 125, neuron specific enolase, and squamous cell antigen level determinations in the serum and pleural fluid of patients with pleural effusions.

BACKGROUND: To the authors' knowledge the role of tumor marker determination in the differential diagnosis of pleural effusions has not been established definitively. The current article reports the results of a study of CYFRA 21-1, carcinoembryonic antigen (CEA), cancer antigen 125 (CA 125), squamous cell antigen (SCC), and neuron specific enolase (NSE) in the serum and pleural fluid of patients with pleural effusions of diverse etiologies. METHODS: One hundred forty-six patients with pleural effusions (43 malignant, 47 tuberculous, 32 miscellaneous benign, and 24 paramalignant) were studied prospectively. Levels of CYFRA 21-1, CA 125, CEA, NSE, and SCC were measured by radioimmunoassay in the pleural fluid in all patients and in the serum in 118 patients. RESULTS: There were no significant differences between the serum and pleural fluid levels of tumor markers with the exception of CA 125, which was higher in the pleural fluid. With maximum specificity, the highest sensitivity in the diagnosis of pleural malignancy was obtained with a combination of CYFRA 21-1 (with a cutoff value of 150 U/L), CEA (with a cutoff value of 40 ng/mL), and CA 125 (with a cutoff value of 1000 ng/mL) in pleural fluid. NSE and SCC added no diagnostic value. The simultaneous use of tumor markers and cytology in pleural fluid increased the sensitivity from 55.8% to 81%. CONCLUSIONS: These findings suggest that a combination of CYFRA 21-1, CEA, and CA 125 in the pleural fluid can be a useful addition to pleural cytology in the diagnosis of malignant pleural effusion.     

血清五种肿瘤标志物联合检测在肺癌诊断中的意义

目的 联合检测CEA、CA-125、CYFRA21-1、NSE和SCC等5种血清肿瘤标志物水平,探讨其在肺癌临床诊断中的意义。方法 采集112例肺癌患者血清样本,其中48例肺腺癌,33例肺鳞状细胞癌和31例小细胞肺癌;同时采集32例良性患者血清样本为对照组,所有诊断均有组织学证实。用电化学发光法检测血清的CEA、CA-125、CYFRA21-1、NSE水平,用微粒子酶联免疫发光法检测SCC水平。计算灵敏度、特异度和阳性预测值。结果 血清CEA、CA-125、CYFRA21-1、NSE和SCC单项检测的灵敏度为54.46%、67.86%、39.29%、38.39%和28.57%,特异度为93.75%、96.88%、93.75%、87.50%和96.88%。血清五项肿瘤标志物联合检测阳性预测值为92.17%,联合检测灵敏度和特异度分别为94.64%和71.87%。结论 血清CEA、CA-125、CYFRA21-1、NSE和SCC水平联合检测对于肺癌的诊断有临床价值,且联合检测可以提高肺癌诊断的敏感性,提高肺癌的检出率。     

肿瘤标志物CYFRA21-1、SCC、CEA、NSE、CA125检验在肺癌诊断中的价值

目的:分析肿瘤标志物细胞角蛋白19片段（CYFRA21-1）、鳞状上皮细胞癌抗原（SCC）、癌胚抗原（CEA）、神经特异性烯醇化酶（NSE）以及糖类癌抗原125（CA125）检验在肺癌诊断中的临床应用价值。方法:将2015年11月至2016年11月于我院收治的74例肺癌患者（肺癌组）、74例肺良性肿瘤患者（良性肿瘤组）作为研究对象,同期选择74例到院体检的健康人群作为健康组。三组患者均在空腹状态下抽取4.0 ml静脉血,离心处理后进行实验室检验。对比三组患者中CYFRA21-1、SCC、CEA、NSE以及CA125水平的变化情况。结果:肺癌组的CYFRA21-1、SCC、CEA、NSE以及CA125水平均高于健康组和良性肿瘤组（P<0.05）。非小细胞肺癌患者的CYFRA21-1、SCC、CEA以及CA125水平均高于小细胞肺癌患者。小细胞肺癌患者的NSE水平显著高于非小细胞肺癌患者（P<0.05）。结论:肺癌患者的CYFRA21-1、SCC、CEA、NSE以及CA125水平将会显著增高,通过联合检测CYFRA21-1、SCC、CEA、NSE以及CA125能够在一定程度上提高肺癌疾病的诊断准确率,对于肺癌疾病的临床诊断和筛查具有十分重要的作用。     

Utility of the serum tumor markers: CYFRA 21.1, carcinoembryonic antigen (CEA), and squamous cell carcinoma antigen (SCC) in squamous cell lung cancer

The aim of this study is to assess the clinical usefulness of serum assays of carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC), and CYFRA 21.1 in the diagnosis of squamous cell lung cancer. Sixty patients with squamous cell, and twenty-four patients with nonsquamous cell histology of nonsmall cell lung cancer were enrolled in this study. Serum CEA, SCC, and CYFRA 21.1 levels were obtained by commercially available kits. Upper cutoff levels were 10 ng/ml, 3.5 ng/ml, and 3.5 ng/ml, respectively. In squamous cell lung cancer, percentages and 95% confidence interval (CI) of the patients with elevated levels were as follows: for CEA 23.3% (13-36), for SCC 20.0% (10-32), and for CYFRA 21.1 85.0% (73-93). The positivity rate of CYFRA 21.1 was more significant than CEA and SCC in both squamous and nonsquamous cell lung cancer. None of the markers were significant in differentiating squamous/nonsquamous histology. Only tumor marker CEA was significantly elevated in metastatic squamous cell lung cancer (p=0.004). A novel tumor marker CYFRA 21.1 can be used as a reliable tumor marker in diagnosing squamous cell lung cancer. In addition, CEA has an important role in determining metastatic disease.     

5种肿瘤标志物联合检测在口腔鳞状细胞癌中的诊断价值

目的:通过检测血清肿瘤标志物（SCC-Ag、CYFRA21-1、CEA、CA125、NSE）探讨联合检测对口腔鳞状细胞癌(oral squamous cell carcinoma,OSCC)的临床诊断意义及诊断效能。方法:收集2015年1月至2018年1月就诊于新疆维吾尔自治区人民医院口腔颌面外科的OSCC患者60例,非OSCC恶性肿瘤患者60例,同期健康体检者60例作为正常组,均抽取空腹外周血2 ml,检测SCC-Ag、CYFRA21-1、CEA、CA125、NSE浓度。结果:OSCC患者的5种血清肿瘤标志物水平与非OSCC恶性肿瘤组、正常组比较差异具有统计学意义(P<0.05)。将CEA、CA125、SCC-Ag、CYFRA21-1、NSE联合检测后敏感性、特异性、准确性、阳性预测值均显著提高。结论:SCC-Ag、CYFRA21-1、CEA、CA125、NSE 5种肿瘤标志物在OSCC中联合检测可以显著提高诊断效能;5种肿瘤标志物的血清表达量在OSCC的临床诊断中具有一定的价值。     

聚类和判别分析法在肺癌六种肿瘤标志物诊断中的应用

目的 探讨聚类和判别分析法在肺癌6种肿瘤标志物诊断中的应用。方法 收集2012年5月至2013年5月新疆医科大学附属肿瘤医院初次入院就诊且最终确诊的肺癌患者342例,在未进行任何治疗前检测其血清中Pro-GRP、CEA、CA125、SCC、CYFRA21-1、NSE的含量。比较六种肿瘤标志物在小细胞肺癌、肺腺癌、肺鳞癌中的差别,应用聚类分析的方法对六个指标进行指标聚类,并对342例样本进行判别分析。结果 NSE和Pro-GRP在小细胞肺癌中的含量明显高于肺鳞癌和肺腺癌;SCC和CYFRA21-1在肺鳞癌中的含量明显高于小细胞肺癌和肺腺癌;CEA和CA125在肺腺癌中的含量明显高于小细胞肺癌和肺鳞癌。聚类分析表明NSE和Pro-GRP是诊断小细胞肺癌的良好指标,而CEA、CA125、SCC、CYFRA21-1却是对诊断非小细胞肺癌具有帮助。利用6种指标建立的判别函数对于小细胞肺癌的诊断符合率为93.3%;对于非小细胞肺癌的诊断符合率为83.0%。结论 利用聚类分析和判别分析的统计方法可以证明NSE、Pro-GRP、CEA、CA125、SCC、CYFRA21-1对肺癌不同病理分型诊断具有不同的应用价值。     

非小细胞肺癌患者血清多项肿瘤标志联合检测的临床意义

目的:评价癌胚抗原(CEA)、鳞状细胞癌相关抗原(SCC-Ag)、细胞角蛋白21-1片段(CYFRA21-1)、糖类抗原125(CA125)、糖类抗原153(CA153)和神经元特异性烯醇华酶(NSE)等6项标志联合检测,在非小细胞肺癌(non-small cell lung cancer,NSCLC)的临床诊断、预后及评价疗效等方面的临床意义。方法:收集284例NSCLC患者的临床资料及肿瘤标志水平,评价标志水平与病情的关系。统计学分析采用SPSS10.0软件,用Kaplan-Merier法计算生存率和无肿瘤生存率,用Log-rank法进行差异检验,对单因素分析中P<0.3的预后因素使用Cox比例风险回归进行多因素分析。结果:肿瘤标志CEA的总阳性率为42.6%,CYFRA21-1为54.2%,SCC为12.6%,CA125为51.8%,CA153为39.4%,NSE为16.5%。6项标志联合检查的总阳性率为80.3%。CEA、CA153阳性患者的化疗疗效较差,而NSE阳性患者的化疗疗效较好。出现转移或病情进展的患者中,73.1%出现阴性标志和(或)经治疗已转为阴性的标志转为阳性。全组患者的中位无病生存期为12.98(2~22)个月,中位生存期为17.69(6~22)个月。结论:CEA、SCC-Ag、CYFRA21-1、CA125、CA153和NSE等6项标志在NSCLC患者中有较高的阳性率。多项标志联合检测的阳性率远高于任一标志单独检测的阳性率。     

晚期NSCLC患者血清CEA、NSE、CYFRA211、CA125、CA199检测的临床及预后意义

目的 探讨晚期非小细胞肺癌（NSCLC）患者血清CEA、NSE、CYFRA211、CA125及CA199水平在临床及预后中的意义。方法 化疗前、后检测95例初治晚期NSCLC患者血清CEA、NSE、CYFRA211、CA125及CA199水平。结果 95例患者疗前血清CEA、NSE、CYFRA211、CA125及CA199的阳性率分别为53．7％、70．5％、62．2％、54．1％及31．6％。化疗后部分缓解者的肿瘤标志物水平均明显下降（P值分别为0．030、0．000、0．009、0．002和0．034）。本组患者1年生存率为52．7％（50／95）,2年生存率为14．7％（14／95）,中位生存14个月（部分缓解者17月,稳定者13月,进展者6月）。COX模型多因素分析表明,患者预后与首程化疗疗效、分期、疗前行为状态、CYFRA211有密切关系,与病理分型、疗前CEA、NSE、CA125及CA199无明显关系。结论 CEA、NSE、CYFRA211、CA125及CA199值下降可评价化疗疗效,NSCLC患者的TNM分期、疗前行为状态、疗前CYFRA211及首程化疗疗效有预后意义。     

血清CYFRA21 1、NSE、CEA、CA125及SCCA联合检测在肺癌诊断中的价值研究

目的探讨联合检测血清细胞角蛋白19片段(CYFRA21 1)、神经元特异性烯醇化酶(NSE)、癌胚抗原(CEA)、糖类抗原125(CA125)、鳞状上皮细胞癌抗原(SCCA)对肺癌的临床诊断价值。方法选取2018年8月至2019年9月在安徽省胸科医院确诊的肺癌患者109例为肺癌组（腺癌61例,鳞癌30例,小细胞癌18例）,肺部良性疾病患者75例为良性肺病组,健康体检者49例为对照组。采用电化学发光法检测各组患者血清中CYFRA21 1、NSE、CEA、CA125及SCCA的表达水平。采用Kruskal Wallis检验、χ2检验比较各组血清CYFRA21 1、NSE、CEA、CA125、SCCA水平和阳性率,采用受试者操作特性曲线（ROC）分析上述5种肿瘤标志物对肺癌的联合诊断价值。结果肺癌组的血清CYFRA21 1、NSE、CEA、CA125、SCCA水平和阳性率明显高于良性肺病组和对照组;腺癌组血清CEA水平高于鳞癌组和小细胞癌组;腺癌组CEA阳性率高于鳞癌组;腺癌组SCCA阳性率高于小细胞癌组;鳞癌组SCCA水平和阳性率高于腺癌组和小细胞癌组;鳞癌组CYFRA21 1水平高于小细胞癌组（P<005）;小细胞癌组NSE水平和阳性率高于腺癌组和鳞癌组,差异均有统计学意义（P<005）。ROC曲线显示5种肿瘤标志物联合检测肺癌及不同病理分型肺癌的ROC曲线下面积（AUC）最大。结论肿瘤标志物CYFRA21 1、NSE、CEA、CA125、SCCA在不同病理分型肺癌中的表达各不相同,联合检测对不同病理分型肺癌的临床诊断价值更大。     

晚期肺鳞癌患者肿瘤标志物测定的临床分析

背景与目的肺鳞癌由于发病隐匿,早期无明显症状,往往到晚期才得以诊断。本研究旨在描述性分析晚期肺鳞癌患者的基本特征和多种肿瘤标志物检测水平及阳性率情况,评价其临床价值。方法以2011年1月-2015年12月期间于中国医学科学院肿瘤医院诊治的晚期肺鳞癌患者作为研究对象,通过病历回顾收集相关资料,描述性分析晚期肺鳞癌患者基本特征、肿瘤标志物检测水平和阳性率。结果260例患者的平均年龄为（59.4±9.2）岁,男性223例（85.8%）,女性37例（14.2%）。203例（78.1%）有吸烟史,8例（3.1%）有癌症家族史。细胞角质蛋白19的片断（cytokerantin 19 fragment, CYFRA21-1）的检测阳性率最高（71.2%）。不同肿瘤原发灶（tumor, T）分期和淋巴结受累（node, N）分期患者五种指标检测水平无统计学差异（P>0.05）,仅鳞状细胞癌相关抗原（squamous cell carcinoma antigen, SCC）在不同T分期的检测阳性率有统计学差异（P=0.035）。二联阳性率最高的为CYFAR21-1+蛋白质类的癌胚抗原（carcinogen-embryonic antigen, CEA）,阳性率为82.7%,三联阳性率最高的为癌抗原12-5（cancer antigen 125, CA125）+CYFAR21-1+CEA,阳性率为84.6%,四联阳性率最高为CA125+CYFAR21-1+CEA+酶类标志物神经烯醇化酶（neuron speciifc enolase, NSE）,阳性率为85.0%,五联的阳性率为86.2%。结论 CYFAR21-1的检测阳性率最高,单项肿瘤标志物的检测灵敏度较低,联合检测可提高对肺鳞癌的诊断灵敏度,首选CA125、CYFAR21-1和CEA联合。     

胸水和血清CEA、CA125、CYFRA21-1、NSE和Pro-GRP联合检测对肺癌的诊断价值

目的:探讨联合检测肺癌胸水和血清中癌胚抗原(CEA)、癌抗原125(CA125)、细胞角蛋白19片段(CYFRA21-1)、神经原特异性烯醇化酶(NSE)和胃泌素释放肽前体(Pro-GRP)5 种肿瘤标志物水平在肺癌临床诊断中的应用价值,以期提高鉴别良恶性胸水的能力。方法:用电化学发光法检测93例肺癌患者和54例肺炎性疾病患者的血清及胸水标本CEA、CA125、CYFRA21-1、NSE和Pro-GRP水平。结果:癌性胸水组中CEA、CA125、CYFRA21-1、NSE和Pro-GRP 5种肿瘤标志物平均水平与炎性胸水组比较,差别均有统计学意义(P<0.05);癌性胸水组中CEA、CYFRA21-1、CA125的含量远远高于炎性胸水组（20~600倍）(P<0.01)。肺癌胸水组中CEA、CA125、CYFRA21-1、NSE和Pro-GRP 5种肿瘤标志物水平与肺癌血清组比较,差别均有统计学意义(P<0.05)。肺癌胸水组中CEA、CYFRA21-1、CA125的含量远远高于肺癌血清组（7~80倍）(P<0.01),相比与正常对照组更是有200倍以上的增高(P<0.01),因此胸水中CEA、CYFRA21-1、CA125百倍左右的升高提示恶性肿瘤的存在。将93例癌性胸水和血清分为腺癌、鳞癌和小细胞癌。腺癌、鳞癌和小细胞癌胸水组中CEA、CA125、CYFRA21-1、NSE和Pro-GRP 5种肿瘤标志物含量明显高于炎性胸水组(P<0.01);腺癌胸水组中CEA含量明显高于鳞癌和小细胞癌(P<0.01);鳞癌胸水组中CYFRA21-1含量明显高于腺癌和小细胞癌(P<0.01);小细胞癌胸水组中NSE和Pro-GRP含量明显高于腺癌和鳞癌(P<0.01)。CA125含量在胸水组中腺癌、鳞癌含量明显高于小细胞癌(P<0.01)。5 种标志物单项及联合检测的灵敏度肺癌胸水组均高于肺癌血清组,肺癌胸水中5项联合检测后灵敏度可达99.11%。结论:肺癌组胸水中CEA、CA125、CYFRA21-1、NSE和Pro-GRP 5种肿瘤标志物联合检测有利于良恶性胸水的鉴别诊断,联合检测可以提高肺癌诊断的灵敏度,当肿瘤标志物显著升高时,CEA可作为肺腺癌的肿瘤标志物;CYFRA21-1可作为肺鳞癌的肿瘤标志物;NSE和Pro-GRP可作为小细胞癌的肿瘤标志物;CA125可作为非小细胞肺癌的肿瘤标志物。     

血清肿瘤标志物对肺癌患者支气管镜活检病理组织学分型的预测价值

目的 探讨血清肿瘤标志物水平与支气管镜活检组织病理学分型的关系。方法 本研究纳入2013年1月—2018年12月于哈尔滨医科大学附属肿瘤医院行支气管镜下活检病理检查,且完成相关血清肿瘤标志物(SCCA、CYFRA21-1、CEA、CA125、NSE)检测的356例肺癌患者(140例小细胞癌、122例鳞状细胞癌、94例腺癌),对患者进行回顾性分析。结果 在支气管镜活检的肺癌患者中,五种血清肿瘤标志物的组合(SCCA+CYFRA21-1+CEA+CA125+NSE,AUC=0.948,P<0.001)对小细胞肺癌与非小细胞肺癌的辅助诊断价值更高;三种(SCC+CEA+NSE,AUC=0.901,P<0.001)或四种(SCC+CYFRA21-1+CEA+NSE,AUC=0.901,P<0.001)标志物联合鉴别鳞状细胞癌与腺癌准确性更高;而在非小细胞肺癌中鉴别鳞状细胞癌与腺癌,三种标志物组合(SCCA+CEA+CA125,AUC=0.831,P<0.001)的价值更高。结论 对于不同病理分型的肺癌患者,不同血清肿瘤标志物组合对支气管镜下活检病理的分型有一定的辅助诊断...     

Prospective evaluation of squamous cell carcinoma and carcinoembryonic antigen as prognostic factors in patients with cervical cancer.

Carcinoembryonic antigen (CEA) and squamous cell carcinoma(SCC) serum levels were prospectively determined in 159 untreated patients diagnosed with carcinoma of the uterine cervix from 1991 to 2001. The histological analysis showed epidermoid cancer in 117 patients, adenocarcinoma in 26 patients, adenosquamous carcinoma in 12 patients and other histological types in the remaining 4 patients. Tumor marker sensitivity was related to the histological type with abnormal SCC (>2 ng/ml) in 51.3% of squamous tumors in contrast to the 7.1% found in other histologies. By contrast, CEA sensitivity was not related to histology with abnormal values (>5 ng/ml) in 25% of squamous tumors, 19% of adenocarcinomas, 33% of adenosquamous carcinomas and 25% of other histologies. CEA and SCC serum levels were clearly related to tumor stage, parametrial invasion, tumor size and nodal involvement. Elevated pretreatment CEA indicates parametrial invasion with a probability of 82%. Likewise, pretreatment CEA and SCC serum levels were of prognostic value, with a shorter disease-free survival and overall survival in patients with abnormal levels. All patients with adenocarcinomas and abnormal CEA had relapse during follow-up. Multivariate analysis indicated that parametrial invasion, age, tumor size and SCC were independent prognostic factors. In conclusion, CEA and SCC are useful tumor markers in carcinomas of the uterine cervix, with a clear relationship with well-known prognostic factors (parametrial invasion, nodal involvement), and are of prognostic value.     

多项肺系统肿瘤标志物异常在晚期肺腺癌治疗中的作用

背景与目的 肺癌的常用肿瘤标志物中,癌胚抗原(carcinoembryonic antigen, CEA)与糖类抗原125(carbohydrate antigen 125, CA125)、细胞角蛋白19片段(cytokeratin 19, CYFRA21-1)与鳞状细胞癌抗原(squamous carcinoma antigen, SCC)、神经元特异性烯醇化酶(neuron specific enolase, NSE)与胃泌素释放肽前体(pro-gastrin-releasing peptide, ProGRP)分别在肺腺癌、肺鳞状细胞癌和小细胞肺癌中有较高表达.本研究旨在通过对比多项肿瘤标志物异常(A组)和仅CEA和/或CA125异常(B组)的两组晚期肺腺癌患者,探讨多项肿瘤标志物异常在疗效评价和预测复发方面的价值.方法 纳入中国医学科学院肿瘤医院的IV期肺腺癌初治病例,回顾性分析其临床数据,包括临床特征、治疗前的血清肿瘤标志物水平、疗效及无进展生存期.结果 除CEA和CA125外,A组异常比率最高的肿瘤标志物是CYFRA21-1(93%),其次是NSE(36%)、SCC(13%)和ProGRP (12%).多项肿瘤标志物异常的患者更易出现远处多部位转移(P<0.001),治疗后的无进展生存期更短(中位时间5.3个月 vs 7.3个月,P=0.016).两组中进行维持治疗的患者均比未行维持治疗的患者复发风险低(P均<0.001).结论 多项肿瘤标志物异常患者复发风险高,维持治疗可降低复发风险.     

TAP与传统肿瘤标志物在不同肿瘤中的相关性

目的:分析肿瘤异常蛋白（TAP）水平与其他10种传统肿瘤标志物在不同类型肿瘤患者中的相关性。方法:采集肺癌、结直肠癌、食管癌、胃癌患者血液样本,采用凝集素亲和方法检测TAP,采用化学发光免疫分析法检测甲胎蛋白（AFP）、癌胚抗原（CEA）、糖类抗原50（CA50）、糖类抗原19-9（CA19-9）、糖类抗原125（CA125）、糖类抗原72-4（CA72-4）、铁蛋白(FRT)、神经元特异性烯醇化酶（NSE）、鳞状细胞癌抗原（SCC）、细胞角蛋白19片段（CYFRA21-1）。采用Spearman分析TAP与传统肿瘤标志物之间的相关性。结果:TAP水平在4种肿瘤患者中无明显差异。肺癌患者中,TAP与CA125、CA19-9、CEA、CYFRA21-1、CA50的相关性具有统计学意义（P<0.05）。结直肠癌患者中,TAP与CA19-9、CEA、CA50、CA72-4、FRT存在显著相关性（P<0.05）。胃癌患者中,TAP与CA125及CA50的相关性具有统计学意义（P<0.05）。食管癌患者中,TAP与10种传统肿瘤标志物均无显著相关性。结论:TAP与10种传统肿瘤标志物在不同类型肿瘤中的相关性并不一致,表明不同类型肿瘤细胞产生的异常糖链糖蛋白种类不同。     

Evaluation of the soluble fragments of cytokeratin 19 (CK19) in non-small cell lung cancer (NSCLC)

This study compared the diagnostic efficacy of serum CK19 determination (Cyfra 21-1) with other tumour markers, such as CEA, SCC, NSE, TPA, in patients with resected non-small lung cancer. Tumour marker levels were tested in 90 patients with benign lung disease and at diagnosis in 72 patients with proven NSCLC, 39 squamous cell carcinoma and 33 adenocarcinoma. At presentation baseline levels of all tumor markers were significantly higher (p<0.05) in lung cancer patients than in control subjects, except for NSE. A significant increase (p<0.05) in serum concentrations was observed from stage I to stage IIIb only for Cyfra 21-1 (stage I/II, median=2.7 ng/ml; stage IIIb, median=6.3 ng/ml) and TPA (stage I/II, median=89.8 IU/ml; stage IIIb, median=170.7 IU/ml). Receiver operating characteristic (ROC) analysis was performed to evaluate the best threshold values and the global accuracy of each marker. The highest global sensitivity for NSCLC was reached by TPA (70.8%), whereas that of Cyfra 21-1 was 50%. According to tumour histology, significant difference (p<0.05) in serum levels were found only for CEA (adenocarcinomas, median=5.6 ng/ml; squamous cell carcinoma, median=3.2 ng/ml) and SCC (adenocarcinomas, median=1.0 ng/ml; squamous cell carcinoma, median=1.5 ng/ml). As regards squamous cell carcinoma histotype, the highest sensitivity was obtained by TPA (74.4% at a specificity of 62.2%) and for adenocarcinomas by CEA (78.8% at a specificity of 85.6%). Tumour marker levels were also determined during the follow-up of 10 patients. The best sensitivity in detecting relapses was shown by CEA (90%), followed by TPA (70%), SCC (50%), Cyfra 21-1 (40%) and NSE (10%), even though the CEA test displayed a high percentage of false positive results (98.1%) in patients with no evidence of disease (NED).     

Tumor markers in lung cancer]

Carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC), neuron-specific enolase (NSE), cytokeratin 19 fragment (CYFRA), and pro-gastrin-releasing peptide (proGRP) can be used as tumor markers for lung cancer. CEA is sensitive for adenocarcinoma, SCC and CYFRA for squamous cell carcinoma, and NSE and proGRP for small cell carcinoma. A tumor marker is generally used as a marker to monitor the clinical course. Serum levels of pro-GRP, reflect the disease course of patients with small cell lung cancer more accurately than NSE or CEA. Among the patients with clinical N0-1 non-small cell lung cancer high serum CEA levels, adenocarcinoma histology, and large tumor dimension were significant predictors of pathologic N2 disease. CEA played a new role in predicting metastasis to mediastinal lymph nodes A more effective treatment may enhance the value of tumor markers to predict relapse.     

血清肿瘤标志物在肺癌诊断中的应用价值*

目的:探讨SCC 、NSE、CEA 、CYFRA21-1 四项肿瘤标志物联合检测对肺癌的诊断价值。方法:采用化学发光法对肺癌组132 例、肺良性疾病组48例和正常对照组92例的血清SCC 、NSE 、CEA 、CYFRA21-1 四项肿瘤标志物进行检测及统计学分析。结果:NSE 、CEA 、CYFRA21-1 在肺癌组显著高于肺良性疾病组和正常对照组,SCC 肺癌组高于正常对照组,CEA 和CYFRA21-1肺良性疾病组显著高于正常对照组。CEA 在肺腺癌中的水平较高,NSE 在小细胞肺癌中的水平较高,而SCC 、CYFRA21-1 在肺鳞癌中的水平较高。单项肿瘤标志物在肺癌诊断中敏感性:NSE>CEA>CYFRA 21-1>SCC;在腺癌中CEA 敏感性最高（58.8%）,鳞癌中CYFRA21-1 敏感性最高（71.4%）,小细胞肺癌中NSE 敏感性最高（50.0%）。 NSE 、CEA 、CYFRA21-1 的ROC 曲线下面积分别为0.928 ± 0.034、0.957 ± 0.026、0.964 ± 0.023,显示诊断准确性较高。SCC 曲线下面积虽然大于0.5,但差异无统计学意义。肿瘤标志物联合检测,可以提高诊断试验的敏感性,在肺癌诊断中NSE 、CEA 、CYFRA21-1 组合敏感性最高（75.6%）,特异性也较好（90.7%）;腺癌诊断中SCC 、NSE 、CEA 组合敏感性最高（73.5%）,鳞癌诊断中NSE 、CEA 、CYFRA21-1 组合敏感性最高（75.8%）,小细胞肺癌中SCC 、NSE 、CYFRA21-1 组合敏感性最高（75.0%）。 结论:SCC 、NSE 、CEA 、CYFRA21-1 对肺癌的诊断均有一定意义,不同病理类型各有特点,选择合适的组合有利于对肺癌的鉴别诊断。      

Preliminary Evaluation of Clinical Utility of CYFRA 21-1, CA 72-4, NSE,CA19-9 and CEA in Stomach Cancer

Background: Although various tumor markers have been utilized in management of stomach cancer (SC), only a few reports have described relevance of examples such as CYFRA 21-1 and neuron-specific enolase (NSE). The purpose of this study was to evaluate the potential diagnostic performance of  carcinoembryonic antigen (CEA), CA 19-9, CA72-4, CYFRA 21-1 and NSE in patients with SC. Materials and Methods: Ninety-six SC patients with pathologic confirmation between 2012 and 2013 were enrolled. Serum levels of five tumor markers were analyzed using a solid-phase immunoradiometric assay. Receiver operating characteristic (ROC) curves were plotted for the five tumor markers to investigate their diagnostic powers and adjusted cutoff values derived from analysis of ROC curves were evaluated to calculate the sensitivity of each for SC with recommended cutoff values. Results: Based on two different cutoff values (recommended and adjusted), CYFRA 21-1 (≥2.0 and 1.2 ng/ml) had a respective sensitivity of 50% and 78.1%, compared with 8.3% and 18.8% for CEA (≥7.0 and 3.9ng/ml), 15.6% and 18.8% for CA 19-9 (≥37 and 26.7 ng/ml), 28.1% and 9.6% for CA 72-4 (≥4.0 and 13 ng/ml) and 7.3% and 7.3% for NSE (≥14.7 and 15.0 ng/ml) in the initial staging of primary SC. The area under the curve (AUC) for CYFRA 21-1, with a value of 0.978 (95% confidence interval, 0.964-0.991) was comparativelythe highest. Univariate analysis revealed significant relationships between tumor marker level and lymph node involvement, metastasis and staging with CYFRA 21-1, CA 72-4 and NSE. Conclusions: CYFRA 21-1 was the most sensitive tumor marker and showed the most powerful diagnostic performance among the five SC tumor markers. NSE and CA 72-4 are significantly related to lymph node involvement, metastasis or stage. Further evaluations are warranted to clarify the clinical usefulness and prognostic prediction of these markers in SC.     

Evaluation of seven tumour markers in pleural fluid for the diagnosis of malignant effusions

Carcinoembryonic antigen (CEA), carbohydrate antigens 15-3, 19-9 and 72-4 (CA 15-3, CA 19-9 and CA 72-4), cytokeratin 19 fragments (CYFRA 21-1), neuron-specific enolase (NSE) and squamous cell carcinoma antigen (SCC) were evaluated in pleural fluid for the diagnosis of malignant effusions. With a specificity of 99%, determined in a series of 121 benign effusions, the best individual diagnostic sensitivities in the whole series of 215 malignant effusions or in the subgroup of adenocarcinomas were observed with CEA, CA 15-3 and CA 72-4. As expected, a high sensitivity was obtained with SCC in squamous cell carcinomas and with NSE in small-cell lung carcinomas. CYFRA and/or CA 15-3 were frequently increased in mesotheliomas. Discriminant analysis showed that the optimal combination for diagnosis of non-lymphomatous malignant effusions was CEA + CA 15-3 + CYFRA + NSE: sensitivity of 94.4% with an overall specificity of 95%. In malignant effusions with a negative cytology, 83.9% were diagnosed using this association. The association CYFRA + NSE + SCC was able to discriminate adenocarcinomas from small-cell lung cancers. Regarding their sensitivity and their complementarity, CEA, CA 15-3, CYFRA 21-1, NSE and SCC appear to be very useful to improve the diagnosis of malignant pleural effusions.