Mr. Sun, 48, went to the hospital for routine chest CT because of cough and sputum, and the doctor suggested that he do four lung cancers at the same time. Regarding the four items of lung cancer, he is not quite sure what to check for? What does it do?
The four lung cancer items are actually four tumor marker indicators that are relatively related to lung cancer, and are checked by drawing blood. The four tumor markers are: CEA, SCC, cyfra211, NSE.
EAA
CEA, known as carcinoembryonic antigen, was first extracted by Gold and Freedman from colon cancer and embryonic tissue in 1965. Looking at the first word "cancer", many people will naturally associate it with cancer, and carcinoembryonic antigens are indeed related to cancer, but they are not reciprocal. It can be said that many benign diseases can also cause increased CEA values, such as liver disease, chronic bronchomegaly, bronchial asthma, active tuberculosis, nonspecific gastrocololitis, pancreatitis, cholecystitis and so on.
Carcinoembryonic antigens have no specificity for tumors of different organs, belong to a broad spectrum of tumor markers, and may be elevated in many kinds of malignant tumors, such as lung cancer, esophageal cancer, gastrointestinal cancer, ovarian cancer, cervical cancer, breast cancer, hepatobiliary and pancreatic malignancy. In fact, the carcinoembryonic antigen is not of great diagnostic value for cancer, and clinical dynamic monitoring is mainly used to evaluate the efficacy of cancer patients, to evaluate prognosis and recurrence, and also to monitor the risk of recurrence and metastasis after surgery.
SCC
SCC, known as squamous cell carcinoma antigen, is a tumor marker used to assist in the diagnosis of squamous cell carcinoma. It may be elevated in patients with squamous cell carcinoma of the lungs, and concentrations may increase with worsening of the disease. Cervical squamous cell carcinoma, head and neck squamous cell carcinoma, esophageal squamous cell carcinoma, nasopharyngeal carcinoma, skin squamous cell carcinoma, vulvar carcinoma, etc. may also be elevated.
Serum SCC may also be mildly elevated in some benign diseases, such as pneumonia, tuberculosis, COPD, psoriasis, eczema, chronic nephritis, renal insufficiency, etc.
SCC is generally not screened for cervical cancer and lung squamous cell carcinoma, the positivity rate is not high, and it is not routinely used as a prognostic judgment for squamous cell carcinoma. It has certain reference value in the monitoring of squamous cell carcinoma efficacy.
cyfra211
Cyfra211, or cytokeratin 19 fragment, is one of the preferred markers for non-small cell lung cancer, especially lung squamous cell carcinoma, which has auxiliary diagnostic value, and some lung adenocarcinomas will also rise. Cyfra211 is an important prognostic evaluation indicator for non-small cell lung cancer, which is persistently elevated and suggests a poor prognosis. It can also be used to monitor efficacy and whether it is recurrent during the treatment of non-small cell lung cancer, and the continuous increase in concentration indicates poor treatment effect and disease progression.
Among other cancers, such as bladder cancer, esophageal cancer, nasopharyngeal cancer, ovarian cancer and cervical cancer, cyfra211 also has varying degrees of positive rates.
There may also be mild elevations in certain benign diseases, such as hepatitis, cirrhosis, pancreatitis, pneumonia, tuberculosis, and renal insufficiency.
NSE
NSE is neuron-specific enolase, serum NSE is one of the preferred markers for small cell lung cancer (SCLC), and serum NSE is an important prognostic evaluation index for small cell lung cancer. If serum NSE is persistently elevated, a poor prognosis is indicated. NSE is also an indicator of treatment effectiveness and monitoring for recurrence.
However, NSE is also a tumor marker for neuroblastoma. Other neuroendocrine tumors such as medullary thyroid cancer, melanoma, islet cell tumor, retinoblastoma, pheochromocytoma, etc. may also be elevated. Certain benign neurological disorders and lung diseases such as meningitis, pneumonia, etc., may also be elevated.
In short, the four items of lung cancer are not used as indicators for screening and diagnosing lung cancer, and general dynamic observation is used as a judgment of the treatment effect and prognosis of patients with confirmed lung cancer. Lung cancer screening and diagnosis mainly rely on chest CT.