Abstract：
UNASSIGNED: Differential diagnosis of non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) in hospitalized patients is crucial for appropriate treatment choice.
UNASSIGNED: To investigate the relevance of serum tumor markers (STMs) and their combinations for the differentiation of NSCLC and SCLC subtypes.
UNASSIGNED: Between 2000 and 2003, 10 established STMs were assessed retrospectively in 311 patients with NSCLC, 128 with SCLC prior systemic first-line therapy and 51 controls with benign lung diseases (BLD), by automatized electrochemiluminescence immunoassay technology. Receiver operating characteristic (ROC) curves and logistic regression analyses were used to evaluate the diagnostic efficacy of both individual and multiple STMs with corresponding sensitivities at 90% specificity. Standards for Reporting of Diagnostic Accuracy (STARD guidelines) were followed.
UNASSIGNED: CYFRA 21-1 (cytokeratin-19 fragment), CEA (carcinoembryonic antigen) and NSE (neuron specific enolase) were significantly higher in all lung cancers vs BLD, reaching AUCs of 0.81 (95% CI 0.76-0.87), 0.78 (0.73-0.84), and 0.88 (0.84-0.93), respectively. By the three marker combination, the discrimination between benign and all malignant cases was improved resulting in an AUC of 0.93 (95% CI 0.90-0.96). In NSCLC vs. BLD, CYFRA 21-1, CEA and NSE were best discriminative STMs, with AUCs of 0.86 (95% CI 0.81-0.91), 0.80 (0.74-0.85), and 0.85 (0.79-0.91). The three marker combination also improved the AUC: 0.92; 95% CI 0.89-0.96). In SCLC vs. BLD, ProGRP (pro-gastrin-releasing peptide) and NSE were best discriminative STMs, with AUCs of 0.89 (95% CI 0.84-0.94) and 0.96 (0.93-0.98), respectively, and slightly improved AUC of 0.97 (95% CI 0.95-0.99) when in combination. Finally, discrimination between SCLC and NSCLC was possible by ProGRP (AUC 0.86; 95% CI 0.81-0.91), NSE (AUC 0.83; 0.78-0.88) and CYFRA 21-1 (AUC 0.69; 0.64-0.75) and by the combination of the 3 STMs (AUC 0.93; 0.91-0.96), with a sensitivity of 88% at 90% specificity.
UNASSIGNED: The results confirm the power of STM combinations for the differential diagnosis of lung cancer from benign lesions and between histological lung cancer subtypes.
UNASSIGNED: To investigate the relevance of serum tumor markers (STMs) and their combinations for the differentiation of NSCLC and SCLC subtypes.
UNASSIGNED: Between 2000 and 2003, 10 established STMs were assessed retrospectively in 311 patients with NSCLC, 128 with SCLC prior systemic first-line therapy and 51 controls with benign lung diseases (BLD), by automatized electrochemiluminescence immunoassay technology. Receiver operating characteristic (ROC) curves and logistic regression analyses were used to evaluate the diagnostic efficacy of both individual and multiple STMs with corresponding sensitivities at 90% specificity. Standards for Reporting of Diagnostic Accuracy (STARD guidelines) were followed.
UNASSIGNED: CYFRA 21-1 (cytokeratin-19 fragment), CEA (carcinoembryonic antigen) and NSE (neuron specific enolase) were significantly higher in all lung cancers vs BLD, reaching AUCs of 0.81 (95% CI 0.76-0.87), 0.78 (0.73-0.84), and 0.88 (0.84-0.93), respectively. By the three marker combination, the discrimination between benign and all malignant cases was improved resulting in an AUC of 0.93 (95% CI 0.90-0.96). In NSCLC vs. BLD, CYFRA 21-1, CEA and NSE were best discriminative STMs, with AUCs of 0.86 (95% CI 0.81-0.91), 0.80 (0.74-0.85), and 0.85 (0.79-0.91). The three marker combination also improved the AUC: 0.92; 95% CI 0.89-0.96). In SCLC vs. BLD, ProGRP (pro-gastrin-releasing peptide) and NSE were best discriminative STMs, with AUCs of 0.89 (95% CI 0.84-0.94) and 0.96 (0.93-0.98), respectively, and slightly improved AUC of 0.97 (95% CI 0.95-0.99) when in combination. Finally, discrimination between SCLC and NSCLC was possible by ProGRP (AUC 0.86; 95% CI 0.81-0.91), NSE (AUC 0.83; 0.78-0.88) and CYFRA 21-1 (AUC 0.69; 0.64-0.75) and by the combination of the 3 STMs (AUC 0.93; 0.91-0.96), with a sensitivity of 88% at 90% specificity.
UNASSIGNED: The results confirm the power of STM combinations for the differential diagnosis of lung cancer from benign lesions and between histological lung cancer subtypes.
摘要：
背景：住院患者的非小细胞肺癌（NSCLC）和小细胞肺癌（SCLC）的鉴别诊断对于选择合适的治疗方案至关重要。
目的：探讨血清肿瘤标志物（STMs）及其组合与NSCLC和SCLC亚型分化的相关性。
方法：在2000年至2003年之间，对311例NSCLC患者中的10例建立的STMs进行了回顾性评估，128例SCLC之前的全身一线治疗和51例良性肺病（BLD）对照，采用自动化电化学发光免疫分析技术。使用受试者工作特征（ROC）曲线和逻辑回归分析来评估单个和多个STM的诊断功效，其相应的敏感性为90％特异性。遵循诊断准确性报告标准（STARD指南）。
结果：CYFRA21-1（细胞角蛋白19片段），CEA（癌胚抗原）和NSE（神经元特异性烯醇化酶）在所有肺癌中明显高于BLD，达到0.81的AUC（95%CI0.76-0.87），0.78（0.73-0.84），和0.88（0.84-0.93），分别。通过三个标记的组合，良性和所有恶性病例之间的区分度得到改善,AUC为0.93(95%CI0.90-0.96).在NSCLC中与BLD,CYFRA21-1、CEA和NSE是最佳区分性STM，AUC为0.86（95%CI0.81-0.91），0.80（0.74-0.85），和0.85（0.79-0.91）。三种标志物组合也提高了AUC:0.92;95%CI0.89-0.96)。在SCLC与BLD,ProGRP（促胃泌素释放肽）和NSE是最好的区别STMs，AUC为0.89(95%CI0.84-0.94)和0.96(0.93-0.98)，分别,联合用药时，AUC略有改善，为0.97（95%CI0.95-0.99）。最后,ProGRP可能区分SCLC和NSCLC(AUC0.86；95%CI0.81-0.91)，NSE（AUC0.83;0.78-0.88）和CYFRA21-1（AUC0.69;0.64-0.75）以及3STM的组合（AUC0.93;0.91-0.96），灵敏度为88%，特异性为90%。
结论：结果证实了STM组合对肺癌与良性病变以及组织学肺癌亚型之间的鉴别诊断的功效。
目的：探讨血清肿瘤标志物（STMs）及其组合与NSCLC和SCLC亚型分化的相关性。
方法：在2000年至2003年之间，对311例NSCLC患者中的10例建立的STMs进行了回顾性评估，128例SCLC之前的全身一线治疗和51例良性肺病（BLD）对照，采用自动化电化学发光免疫分析技术。使用受试者工作特征（ROC）曲线和逻辑回归分析来评估单个和多个STM的诊断功效，其相应的敏感性为90％特异性。遵循诊断准确性报告标准（STARD指南）。
结果：CYFRA21-1（细胞角蛋白19片段），CEA（癌胚抗原）和NSE（神经元特异性烯醇化酶）在所有肺癌中明显高于BLD，达到0.81的AUC（95%CI0.76-0.87），0.78（0.73-0.84），和0.88（0.84-0.93），分别。通过三个标记的组合，良性和所有恶性病例之间的区分度得到改善,AUC为0.93(95%CI0.90-0.96).在NSCLC中与BLD,CYFRA21-1、CEA和NSE是最佳区分性STM，AUC为0.86（95%CI0.81-0.91），0.80（0.74-0.85），和0.85（0.79-0.91）。三种标志物组合也提高了AUC:0.92;95%CI0.89-0.96)。在SCLC与BLD,ProGRP（促胃泌素释放肽）和NSE是最好的区别STMs，AUC为0.89(95%CI0.84-0.94)和0.96(0.93-0.98)，分别,联合用药时，AUC略有改善，为0.97（95%CI0.95-0.99）。最后,ProGRP可能区分SCLC和NSCLC(AUC0.86；95%CI0.81-0.91)，NSE（AUC0.83;0.78-0.88）和CYFRA21-1（AUC0.69;0.64-0.75）以及3STM的组合（AUC0.93;0.91-0.96），灵敏度为88%，特异性为90%。
结论：结果证实了STM组合对肺癌与良性病变以及组织学肺癌亚型之间的鉴别诊断的功效。
