Clinical Evaluation of Tumor Markers for Diagnosis in Patients with Non-small Cell Lung Cancer in China

  • Ma, Li (PLA General Hospital) ;
  • Xie, Xiao-Wei (Department of Respiration, First Affiliated Hospital of PLA General Hospital) ;
  • Wang, Hai-Yan (Department of Respiration, First Affiliated Hospital of PLA General Hospital) ;
  • Ma, Ling-Yun (Department of Respiration, First Affiliated Hospital of PLA General Hospital) ;
  • Wen, Zhong-Guang (Department of Respiration, First Affiliated Hospital of PLA General Hospital)
  • 발행 : 2015.07.13


Background: To evaluate the value of combined detection of serum carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1), and carbohydrateantigen 125 (CA125) for the clinical diagnosis of nonsmall cell lung cancer (NSCLC). Materials and Methods: Serum CEA, CYFRA21-1 and CA125 were assessed in 140 patients with NSCLC, 90 patients with benign lung disease and 90 normal control subjects, and differences of expression were compared in each group, and joint effects of these tumor markers in the diagnosis of NSCLC were analyzed. Results: Serum CEA, CYFRA21-1 and CA125 in patients with NSCLC were significantly higher than those with benign lung disease and normal controls (P<0.05). The sensitivity of CEA, CYFRA21-1 and CA125 were 49.45%, 59.67%, and 44.87% respectively. As expected, combinations of these tumor markers improved their sensitivity for NSCLC. The combined detection of CEA + CYFRA21-1 was the most cost-effective combination which had higher sensitivity and specificity in NSCLC. Elevation of serum CEA and CYFRA21-1 was significantly associated with pathological types (P<0.05) and elevation of serum CEA, CYFRA21-1 and CA125 was significantly associated with TNM staging (P<0.05). Conclusions: Single measurement of CEA, CYFRA21-1 and CA125 is of diagnostic value in the diagnosis of lung cancer, and a joint detection of these three tumor markers, could greatly improve the sensitivity of diagnosis on NSCLC. Combined detection of CEA + CYFRA21-1 proved to be the most economic and practical strategy in diagnosis of NSCLC, which can be used to screen the high-risk group.


  1. Atherly AJ, Camidge DR (2012). The cost-effectiveness of screening lung cancer patients for targeted drug sensitivity markers. Br J Cancer, 106, 1100-6.
  2. Chang S, Dai M, Ren JS, et al (2012). [Estimates and prediction on incidence, mortality and prevalence of lung cancer in China in 2008]. Zhonghua Liu Xing Bing Xue Za Zhi, 33, 391-4.
  3. Ferrigno D, Buccheri G, Biggi A (1994). Serum tumour markers in lung cancer: history, biology and clinical applications. Eur Respir J, 7, 186-97.
  4. Foa P, Fornier M, Miceli R, et al (1999). Tumour markers CEA, NSE, SCC, TPA and CYFRA 21.1 in resectable non-small cell lung cancer. Anticancer Res, 19, 3613-8.
  5. Hammarstrom S (1999). The carcinoembryonic antigen (CEA) family: structures, suggested functions and expression in normal and malignant tissues. Semin Cancer Biol, 9, 67-81.
  6. Henschke CI, Yankelevitz DF (2008). CT screening for lung cancer: update 2007. Oncologist, 13, 65-78.
  7. Hu LA, Fu Y, Zhang DN, et al (2013). Serum IL-33 as a diagnostic and prognostic marker in non- small cell lung cancer. Asian Pac J Cancer Prev, 14, 2563-6.
  8. Kav S, Tokdemir G, Tasdemir R, et al (2012). Patients with cancer and their relatives beliefs, information needs and information-seeking behavior about cancer and treatment. Asian Pac J Cancer Prev, 13, 6027-32.
  9. Liu YC, Zhou SB, Gao F, et al (2013). Chemotherapy and late course three dimensional conformal radiotherapy for treatment of patients with stage III non- small cell lung cancer. Asian Pac J Cancer Prev, 14, 2663-5.
  10. Lu YY, Huang XE, Xu L, et al (2013). Potential predictors of sensitivity to pemetrexed as first-line chemotherapy for patients with advanced non-squamous NSCLCs. Asian Pac J Cancer Prev, 14, 2005-8.
  11. Malik PS, Sharma MC, Mohanti BK, et al (2013). Clinico-pathological profile of lung cancer at AIIMS: a changing paradigm in India. Asian Pac J Cancer Prev, 14, 489-94.
  12. Oguz A, Unal D, Tasdemir A, et al (2013). Lack of any association between blood groups and lung cancer, independent of histology. Asian Pac J Cancer Prev, 14, 453-6.
  13. Pamies RJ, Crawford DR (1996). Tumor markers. An update. Med Clin North Am, 80, 185-99.
  14. Parkin DM, Bray F, Ferlay J, et al (2005). Global cancer statistics, 2002. CA Cancer J Clin, 55, 74-108.
  15. Plavec G, Ninkovic M, Kozlovacki G, et al (2002). [Tumor markers in pleural effusions in bronchogenic carcinoma and tuberculosis]. Vojnosanit Pregl, 59, 23-8.
  16. Ramshankar V, Krishnamurthy A (2013). Lung cancer detection by screening - presenting circulating miRNAs as a promising next generation biomarker breakthrough. Asian Pac J Cancer Prev, 14, 2167-72.
  17. Rasmuson T, Bjork GR, Damber L, et al (1983). Tumor markers in bronchogenic carcinoma. An evaluation of carcinoembryonic antigen, tissue polypeptide antigen, placental alkaline phosphatase and pseudouridine. Acta Radiol Oncol, 22, 209-14.
  18. Stieber P, Dienemann H, Hasholzner U, et al (1994). Comparison of CYFRA 21-1, TPA and TPS in lung cancer, urinary bladder cancer and benign diseases. Int J Biol Markers, 9, 82-8.
  19. Xie X, Zhao Y, Snijder RA, et al (2013). Sensitivity and accuracy of volumetry of pulmonary nodules on low-dose 16- and 64-row multi-detector CT: an anthropomorphic phantom study. Eur Radiol, 23, 139-47.

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