title: Clinical utility of haptoglobin in combination with CEA, NSE and CYFRA21-1 for diagnosis of lung cancer.
abstract: OBJECTIVE
  To investigate the clinical value in lung cancer of a combination of four serum tumor markers, haptoglobin (Hp), carcinoembryonic antigen (CEA), neuron specific enolase (NSE) as well as the cytokeratin 19 fragment (CYFRA21-1).
  
  
  METHODS
  Serum Hp (with immune-turbidimetric method), CEA, NSE, CYFRA21-1 (with chemiluminescence method) level were assessed in 193 patients with lung cancer, 87 patients with benign lung disease and 150 healthy controls. Differences of expression were compared among groups, and joint effects of these tumor markers for the diagnosis of lung cancer were analyzed.
  
  
  RESULTS
  Serum tumor marker levels in patients with lung cancer were obviously higher than those with benign lung disease and normal controls (p<0.01). The sensitivities of Hp, CEA, NSE and CYFRA21-1 were 43.5%, 40.9%, 23.3% and 41.5%, with specificities of 90.7%, 99.2%, 97.9% and 97.9%. Four tumor markers combined together could produce a positive detection rate of 85.0%, significantly higher than that of any single test. With squamous carcinomas, the positive detection rates with Hp and CYFRA21-1 were higher than that of other markers. In the adenocarcinoma case , the positive detection rate of CEA was higher than that of other markers. For small cell carcinomas, the positive detection rate of NSE was highest. The area under receiver operating characteristic curve (AUCROC) of Hp in squamous carcinoma (0.805) was higher than in adenocarcinoma (0.664) and small cell carcinoma (0.665).
  
  
  CONCLUSIONS
  Hp can be used as a new serum tumor marker for lung cancer. Combination detection of Hp, CEA, NSE and CYFRA21-1 could significantly improve the sensitivity and specificity in diagnosis of lung cancer, and could be useful for pathological typing.
authors.affiliation: Department of Clinical Lab, the 81th Hospital of PLA, Nanjing, China E-mail : mapleqh@126.com.
authors.forename: Bing
authors.initials: B
authors.lastname: Wang
authors.forename: Yu-Jie
authors.initials: YJ
authors.lastname: He
authors.forename: Ying-Xing
authors.initials: YX
authors.lastname: Tian
authors.forename: Rui-Ning
authors.initials: RN
authors.lastname: Yang
authors.forename: Yue-Rong
authors.initials: YR
authors.lastname: Zhu
authors.forename: Hong
authors.initials: H
authors.lastname: Qiu
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis; D000951:Antigens, Neoplasm / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood*; D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000175:diagnosis; D006242:Haptoglobins / Q000378:metabolism*; D006801:Humans; D053539:Keratin-19 / Q000097:blood*; D008175:Lung Neoplasms / Q000097:blood* / Q000175:diagnosis; D010751:Phosphopyruvate Hydratase / Q000097:blood*; D012680:Sensitivity and Specificity; D055752:Small Cell Lung Carcinoma / Q000097:blood / Q000175:diagnosis
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D006242:Haptoglobins; D053539:Keratin-19; C102012:antigen CYFRA21.1; D010751:Phosphopyruvate Hydratase