the rapid development of modern society, people’s quality of life has been greatly improved, but many strange diseases have also appeared , Make patients suffer, make doctors annoy, for example: cancer. Among them, the incidence of lung cancer is higher than other cancer types. There are 600,000 new lung cancer patients in my country each year. The number of patients who die from lung cancer is 490,000 cases each year. Lung cancer has also become a high risk factor for death. With the spread of cancer knowledge, people have also learned that to improve the survival rate of lung cancer, it is necessary to achieve early detection. This article briefly discusses lung cancer tumor markers for reference only.
An overview of tumor markers in lung
cancer since the early onset occult, compared with breast cancer, liver cancer, esophageal cancer, early onset and no effective diagnostic method. When lung cancer is diagnosed, 80% of patients have advanced to the advanced stage, delaying the best treatment time. Experts suggest that adults should undergo a health checkup every year for early detection and early treatment. People are very unfamiliar with the tumor markers for lung cancer diagnosis in the physical examination, and they cannot know whether there are cancer cells in the lungs. The following is a simple analysis of various indicators of lung cancer tumor markers to help everyone understand the relevant knowledge.
According to the WHO pathology analysis, lung cancer includes small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC), and more than 80% are non-small cell lung cancer. Non-small cell lung cancer includes squamous cell carcinoma, large cell lung cancer, and adenocarcinoma. Only by selecting corresponding tumor markers for these two types of lung cancer can the disease be accurately diagnosed. Among them, small cell carcinoma is also called oat cell carcinoma, which has the characteristics of high malignancy and poor prognosis. Markers include neuron-specific enolase (NSE), gastrin releasing peptide precursor (ProGRP), carbohydrate antigen 125 (CA125), carbohydrate antigen 153 (CA153), etc. Non-small cell lung cancer is a high-incidence type of lung cancer, which can be divided into squamous cell carcinoma, adenocarcinoma, and adenosquamous mixed carcinoma. Tumor markers mainly use carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), carbohydrate antigen 153 (CA153), etc.
Tumor markers can be used as an important indicator for accurate judgment of lung cancer. When abnormal values are detected, pathological examinations are required to confirm whether lung cancer is diagnosed, and the type of lung cancer must be determined, so as to formulate treatment plans. Surgery can be selected for patients with early lung cancer, and chemotherapy or surgery plus chemotherapy for mid-term patients. For small cell lung cancer, surgery or surgery plus radiotherapy and chemotherapy are more options. When the disease progresses to an advanced stage, the patient no longer has the conditions for surgery, and receiving radiotherapy and chemotherapy will also produce greater side effects, and the treatment effect is not ideal. You can choose molecular targeted therapy to control the further growth of tumors, thereby helping patients prolong their survival.
2. Specific analysis of lung cancer tumor markers
1. Carcinoembryonic antigen (CEA)
CEA is derived from immunoglycoprotein and is a broad-spectrum tumor marker. It mostly occurs in malignant tumors such as lung cancer, colon cancer and breast cancer. The use of CEA in the diagnosis of non-small cell lung cancer can be used as an accurate and reliable tumor marker analysis, and CEA screening can also screen the positive rate early. Clinical studies have found that the positive rate of screening accounts for 40-80%. This tumor marker can also be used to accurately stage NSCLC and has an important predictive effect.
CEA clinical analysis found that the possible cancer types of this marker include colorectal cancer, gastric cancer, etc. The normal reference value range of CEA is 0-5ng/ml. This index is used for lung cancer staging and prognostic evaluation. The more serious the disease progresses, the higher the index concentration. The influencing factors for the detection of this marker are smoking, which will increase the concentration of CEA. Therefore, CEA cannot be used to evaluate the prognosis of lung cancer squamous cell carcinoma, because most patients with lung cancer squamous cell carcinoma are smokers.
2. Carbohydrate antigen (CA125)
CA125 is derived from ovarian cancer epithelial tissue. When the value rises, it indicates that there may be a risk of cervical cancer and ovarian cancer. In the detection of lung cancer serum CA125, 60-70% of patients will be positive, indicating that screening CA125 can be used for early disease screening and for prognostic determination.
CA125 also showed an increase in non-small cell carcinoma and lung cancer, and the increase in lung adenocarcinoma was even more pronounced. The reference normal range of CA125 is 0-35U/ml. The use of CA125 in the diagnosis of lung adenocarcinoma revealed a significant increase in the value, and it can be combined with other indicators to detect it, which can significantly increase the detection rate of lung cancer diagnosis. The detection value of this index will not be affected by factors such as tumor size, stage and tissue type, and this index can also be used as an independent prognostic index in the later stage. The influencing factors for this index screening include age. When the age increases and after menopause, the body’s CA125 level decreases significantly, and ovarian cysts will cause the value to increase.
3. Squamous cell carcinoma antigen (SCC)
SCC can directly participate in the regulation of tumor cells. Among different types of lung cancer, lung squamous cell carcinoma has high diagnostic specificity. When the SCC increases, it indicates that the malignant degree of the tumor is increased, the condition is worsening, and there is even the risk of disease and recurrence and metastasis. It can be used for the diagnosis of disease efficacy and the prognostic evaluation of the treatment effect.
The normal reference value range of SCC tumor markers is 0-1.5ng/ml. SCC assisted diagnosis, the positive rate of clinical diagnosis is 46%, which can confirm the progress of tumor disease and the progress of cervical cancer. The influencing factor that affects the value of SCC tumor markers is that when patients with hepatitis, liver cirrhosis, pneumonia, tuberculosis, and renal failure, the value of SCC will increase.
4. Neuron-specific enolase (NSE)
increased serum NSE (<12ng/ml) is considered as a marker of small cell bronchial carcinoma. The highest level of NSE is in the brain tissue, and it is abnormally expressed. The level of NSE can be used as a diagnostic indicator of the patient’s tumor burden and survival before treatment. The NSE test value was used as the standard for evaluating the prognosis of patients. When the value is high, it indicates a poor prognosis. NSE is also a sensitive and specific indicator for the diagnosis of small cell carcinoma, with a sensitivity of 74%. The content in remission period is normal. An increase in NSE is a recurrence.
The NSE diagnostic value reference range is 0-16.3ng/ml. Using this indicator in the diagnosis of lung cancer can differentiate between small cell lung cancer and non-small cell lung cancer. 70% of patients with SCLC found an increase in NSE value, and the increase in NSE value of other lung cancer types accounted for only 10-20%. NSE can be used as an important indicator for clinical monitoring of lung cancer. The influencing factors for NSE indicator monitoring include long-term drinking, renal dialysis and other people. Most of these people will detect NSE levels higher than normal people.
5. Pro-gastrin releasing peptide fragment (Pro-GRP)
Pro-GRP, this indicator is used as a diagnostic indicator of SCLC, with a sensitivity of 85%. This indicator is a specific secretion in the body, which is less in normal people and can be clearly distinguished from cancer patients. Combined with clinical auxiliary diagnosis of small cell lung cancer.
6. Cytokeratin 19 fragment (CYFRA21-1)
CYFRA21-1 is the apoptotic fragment keratin of alveolar epithelial cells, which is degraded into the blood and is a soluble substance. The sensitivity of the diagnosis of lung squamous cell carcinoma reaches 93.5%, which plays an important role in the diagnosis of lung squamous cell carcinoma. The reference normal range is 0-3.3ng/ml.
In short, the combined detection of tumor markers guides clinical diagnosis and treatment. The gold standard for tumor diagnosis is pathological testing, and an abnormality of a certain marker cannot be used as a diagnostic criterion for tumors.
