ObjectiveTo evaluate the combination diagnostic efficacy of five serum tumor markers in lung cancer based on propensity score-matched method.

MethodsSixty-five lung cancer patients and 129 pneumonia patients from respiratory medicine clinic were divided into the lung cancer group and control group, respectively.The serum levels of CEA, NSE, CYFRA21-1, Pro-GRP and SCC were detected using electrochemical luminescence method.The confounding factors were removed by propensity score-matched method.The receiver operating characteristic curves were drawn to compare the diagnostic efficacy of five serum tumor markers, either alone or in combination.

ResultsFifty-seven cases were matched with lung cancer group and control group by 1:1 propensity score matched method.The serum levels of CEA, CYFRA21-1 and NSE in lung cancer group were significantly higher than those in control group(P < 0.01), and the differences of the serum levels of Pro-GRP and SCC between two groups were not statistically significant(P>0.05).According to the pathological types, the matched lung cancer group was divided into the squamous cell carcinoma group(20 cases) and adenocarcinoma group(37 cases), and the results showed that the levels of CYFRA21-1, CEA and NSE in adenocarcinoma group and NSE level in squamous cell carcinoma group were significantly higher than those in control group(P < 0.01).The serum CEA, CYFRA21-1 and NSE in lung cancer group showed better diagnostic efficacy(P < 0.05).The diagnostic efficiency of multi-indicator combination was higher than that of single indicator, and there was no statistical significance in diagnostic efficacy among different combinged strategies(P>0.05).The Youden index of multi-indicator combination in the diagnosis of adenocarcinoma was higher than that of squamous cell carcinoma.

ConclusionsThe combination of multiple indicators can improve the diagnostic efficiency of lung cancer, especially for adenocarcinoma.