The significance of serum HE4, VEGF and CYFRA21-1 in the diagnosis of non-small cell lung cancer and their relationship with clinicopathological features

Objective To investigate the diagnostic value of serum tumor markers levels HE4, VEGF and CYFRA21-1 in non-small cell lung cancer (NSCLC) and its correlation with the clinicopathological features of NSCLC. Methods The levels of serum HE4, VEGF and CYFRA21-1 were measured by enzyme-linked immunosorbent assay (ELISA) using samples from 60 primary NSCLC patients, 55 patients with benign lung diseases or pneumonia and 55 healthy subjects. Results The NSCLC group produced remarkable higher levels of serum HE4, VEGF and CYFRA21-1 than the benign and healthy control groups (P<0.05). The levels of serum HE4, VEGF and CYFRA21-1 were significantly higher in patients on stages Ⅲ and Ⅳ than those on stages Ⅰ and Ⅱ (P<0.05). The levels of serum HE4, VEGF and CYFRA21-1 increased in patients with lymph node metastasis, compared with those without lymph node metastasis (P<0.05). There was no significant relationship between the serum levels of the three tumor markers and patients' age, sex and tumor T stage (P>0.05). The levels of serum HE4 and VEGF were not related with the pathological type of lung cancer, while the level of serum CYFRA21-1 was significantly higher in squamous cell carcinoma patients than those with adenocarcinoma (P<0.05). According to ROC curve, the AUC of serum HE4, VEGF and CYFRA21-1 was 0.803, 0.857 and 0.751, respectively, which was higher than the AUC of 0.895 for the combination of the three markers. The sensitivity of serum HE4, VEGF and CYFRA21-1 was 71.7%, 77.4%and 73.3%, respectively. The specificity of serum HE4, VEGF and CYFRA21-1 was 80.8%, 84.2% and 75.8%, respectively. The diagnostic sensitivity of a combination of HE4, VEGF and CYFRA21-1 increased to 91.7%, while the specificity of the combined use decreased to 80.3%. Conclusions The levels of serum HE4, VEGF and CYFRA21-1 significantly increase in NSCLC patients, which are closely related to a number of clinicopathological parameters. The new combined detection can improve the diagnostic efficiency and contribute to the early detection of NSCLC.