Serum Markers CA125, CYFRA21-1, FGF2, HE4, β-hCG, and AFP, along with Inflammatory Cytokines (Prolactin, SCF, OPN, and VEGF), in Lung Cancer Diagnosis

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Abstract Lung carcinoma is a malignant tumor that begins in the lung and is largely represented by non-small cell lung cancer, which remains the leading cause of cancer-related death worldwide. It is very important to put emphasis on the early detection and treatment of lung carcinoma. This study aims to provide evidence for the clinical use of conventional serum markers cancer antigen 125 (CA125), cytokeratin 19 fragment antigen 21-1, fibroblast growth factor 2 (FGF2), human epididymis protein 4, human chorionic gonadotropin, and alpha-fetoprotein, along with inflammatory cytokines (prolactin, stem cell factor, osteopontin, and vascular endothelial growth factor) in lung cancer management. From December 2024 to March 2025, 91 lung cancer patients and 100 healthy subjects from Sechenov University's Institute of Personalized Oncology, Moscow, Russia, were enrolled in this study. Fasting blood samples were collected with the help of a standard venipuncture method to determine its expression in serum. We used the chi-square and Mann–Whitney's U tests to compare differences between groups, and employed multivariate logistic regression to identify independent risk factors. Diagnostic performance, including sensitivity, specificity, and area under the curve (AUC) values, was evaluated through receiver operating characteristic (ROC) curve analysis. All data analysis was conducted using SPSS version 27. Lung cancer patients had significantly greater serum levels of CA125 and prolactin than controls (all p < 0.05), while FGF2 levels were significantly higher in controls than in cases. CA125 and age were identified as independent risk factors for lung cancer in multivariate logistic regression analysis. Prolactin had an AUC of 0.65 with 47.8% sensitivity and 80.6% specificity (all p < 0.05) in ROC analysis, whereas CA125 had an AUC of 0.64 with 44.6% sensitivity and 85.7% specificity. CA125 and prolactin are elevated and independently associated with lung cancer. Their high specificity and moderate sensitivity imply that they may be useful in conjunction with other markers or imaging tests to improve identification and risk assessment.

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