The rapid development of society brings us high-quality life, as well as diseases, one of the most fearful is cancer. And lung cancer is the most common among all cancers. Lung cancer is one of the most common and serious types of cancer. Around 44,500 people are diagnosed with the condition every year in the UK and an estimated 174,000 are diagnosed in Americans each year.
We know that the key to improving the 5-year survival rate of lung cancer is early diagnosis and correct treatment. Serum tumor marker detection is the best method for non-invasive screening of early lung cancer. So what are the tumor markers related to lung cancer, and what are the characteristics of lung cancer in different pathological types?
Carcinoembryonic antigen (CEA)
1. CEA: the most broad-spectrum and most clinically used tumor marker.
2. Related tumors: colorectal cancer, pancreatic cancer, stomach cancer, liver cancer, lung cancer, breast cancer, ovarian cancer.
3. Normal reference value: 0-5 ng/ml.
4. Clinical application: an important indicator of lung cancer staging and prognosis assessment. The later the patient's period, the higher the CEA concentration.
5. Influencing factors: smoking (causing a high concentration of CEA), which made it a poor marker for the prognosis of lung squamous cell carcinoma (SCC) since the proportion of smoking in patients is as high as 92.3%.
Neuron specific enolase (NSE)
1. NSE: Neuron-specific enolase, the most sensitive indicator of small cell lung cancer (SCLC).
2. Related tumors: small cell lung cancer, neuroendocrine cell tumor (pheochromocytoma), islet cell tumor, medullary thyroid carcinoma, melanoma, retinoblastoma.
3. Reference range: 0-25ng/ml.
4. Clinical application: can be used as a differential diagnosis of small cell lung cancer and non-small cell lung cancer (NSCLC) (70% of SCLC patients with elevated blood NSE, while other tissue type lung cancer patients with elevated NSE only 10-20 %), and lung cancer monitoring indicators.
5. Influencing factors: The NSE level of people with long-term drinking and kidney dialysis will be high.
Cytokeratin 19 fragment (CYFRA21-1)
1. CYFRA21-1: an acidic peptide mainly distributed in the alveolar epithelium, which is significantly elevated in the serum of patients with advanced lung cancer.
2. Related tumors: lung cancer (squamous cell carcinoma > adenocarcinoma > large cell carcinoma > small cell carcinoma), invasive bladder cancer, head and neck, breast, cervix, digestive tract tumor.
3. Reference range: 0-5ng/ml
4. Clinical application: is important for non-small cell lung cancer (the positive detection rate of various types of non-small cell lung cancer is 70% to 85%); an effective index for tracking early recurrence after lung cancer surgery and radiotherapy (The level of serum CYFRA21-1 concentration is positively correlated with the clinical stage of the tumor).
5. Influencing factors: pneumonia, tuberculosis, bronchitis, bronchial asthma, emphysema and other diseases. Benign liver disease and renal failure can cause a slight increase, but rarely exceed 10 ng/ml.
Squamous cell carcinoma antigen (SCCA)
1. SCCA: squamous cell carcinoma antigen, a well-targeted SCC marker.
2. Related tumors: cervical cancer, lung squamous cell carcinoma, head and neck cancer, vulvar cancer, bladder cancer, anal canal cancer, skin cancer.
3. Reference range: 0-1.5 ng/ml
4. Clinical application: Auxiliary diagnosis of lung squamous cell carcinoma, the positive rate is 46.5%, which is related to the degree of tumor progression; it has a higher diagnostic value for cervical cancer.
5. Influencing factors: hepatitis, cirrhosis, pancreatitis, pneumonia, tuberculosis, renal failure, psoriasis and other diseases.
Carbohydrate antigen 125 (CA125)
1. CA125: carbohydrate antigen 125. A marker for epithelial ovarian cancer and endometrial cancer. It is also significantly elevated in patients with non-small cell lung cancer, especially in lung adenocarcinoma.
2. Related tumors: breast cancer, pancreatic cancer, stomach cancer, lung cancer, colorectal cancer, other gynecological tumors.
3. Reference range: 0-35U/ml
4. Clinical application: CA125 increased significantly in lung adenocarcinoma, combined detection can improve the detection rate of lung cancer; at the same time it is not affected by tumor size, stage, tissue type, etc., can be used as an independent prognostic indicator in lung cancer detection .
5. Influencing factors: CA125 levels decreased when people get older or menopause, while endometriosis, pelvic inflammatory disease, ovarian cysts, pancreatitis, hepatitis, cirrhosis, etc. increased it to some extent.
Gastrin-releasing peptide precursor (ProGRP)
1. ProGRP: Gastrin-releasing peptide precursors can reach 66% elevation in small cell lung cancer, which is much higher than that in other tumors and small cell lung cancer.
2. Related tumors: lung cancer, breast cancer, cervical cancer, colorectal cancer, liver cancer and so on.
3. Clinical application: has a better diagnosis specificity for small cell lung cancer, SCLC and other lung diseases; at the same time, it can be used for clinical efficacy judgment and early detection of recurrence.
4. Influencing factors: elevated levels of ProGRP in the blood of patients with chronic renal failure or thyroid or prostate tumors
Finally, we summarize these tumor markers in one sentence based on clinical application:
Carcinoembryonic antigen (CEA): a broad-spectrum marker for combined prognostic evaluation of lung adenocarcinoma.
Neuron-specific enolase (NSE): a small cell lung cancer-specific indicator.
Gastrin-releasing peptide precursor (ProGRP): a small cell lung cancer-specific indicator.
Cytokeratin 19 fragment (CYFRA21-1): the most sensitive indicator of non-small cell lung cancer
Squamous cell carcinoma antigen (SCC): combined detection improves the detection rate of lung squamous cell carcinoma
Sugar chain antigen 125 (CA125): combined detection improves the detection rate of lung adenocarcinoma