肺腺癌患者临床参数与血清标志物的相关性分析
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摘要
目的探讨肺腺癌患者临床参数与血清标志物的相关性。方法采用回顾性研究方法,对上海中医药大学附属龙华医院肿瘤二科肺腺癌住院患者的临床参数与癌胚抗原(carcinoembryonic antigen,CEA)、糖类抗原125(carbohydrate antigen 125,CA125)、糖类抗原15-3(carbohydrate antigen 15-3,CA153)、糖类抗原50(carbohydrateantigen 50,CA50)、糖类抗原19-9(carbohydrate antigen,CA19-9)、细胞角蛋白19片段(cytokeratin 19 fragment,CYFRA21-1)及C反应蛋白(C-reactive protein,CRP)七种血清标志物等数据进行Logistic相关性回归模型构建,分析患者临床参数与血清指标的相关性。结果在199例肺腺癌患者中,7项血清指标在肿瘤原发左右肺部位不同的患者间比较,差异均不具有统计学意义(P>0.05);患者的性别、年龄、TNM分期,与其CEA水平无相关性(P>0.05)。CA153、CA125、CA50、CA19-9、CYFRA21-1、CRP与TNM分期具有相关性(P<0.05);CYFRA21-1、CRP水平与性别具有相关性(P<0.05)。结论 7种血清肿瘤标志物与肿瘤原发部位在左右侧肺均无关;患者的性别、年龄、TNM分期,不是导致其CEA水平升高的相关危险因素;女性肺腺癌患者的血清CYFRA21-1、CRP含量高于男性患者;CA-153、CA-125、CA-50、CA-19-9、CYFRA21-1、CRP含量高的肺腺癌患者,其TNM分期越高。
Objective To investigate the correlation of clinical parameters with serum markers in patients with lung adenocarcinoma.Methods Serum carbohydrate antigen(CEA),carbohydrate antigen 125(CA125),carbohydrate antigen 15-3(CA153),carbohydrate antigen 50(CA50),carbohydrate antigen 19-9(CA19-9),cytokeratin 19 fragment(CYFRA21-1) and C-reactive protein(CRP) were measured in 199 patients with lung adenocarcinoma.Logistic regression model was used to analyze the correlation of clinical parameters with serum markers.Results There were no significant differences in serum marker levels between patients with left and right side of lung cancer(P>0.05).The gender,age and TNM stage of the patient were not correlated with CEA level(P>0.05).CA153,CA125,CA50,CA19-9,CYFRA21-1,CRP levels were correlated with TNM staging(P<0.05).CYFRA21-1 and CRP levels were correlated with gender(P<0.05).Conclusion The serum CYFRA21-1 and CRP levels of female lung adenocarcinoma patients was higher than those of male patients.Patients with high serum levels of CA-153,CA-125,CA-50,CA-19-9,CYFRA21-1 and CRP have higher TNM stages of lung adenocarcinoma.
Objective To investigate the correlation of clinical parameters with serum markers in patients with lung adenocarcinoma.Methods Serum carbohydrate antigen(CEA),carbohydrate antigen 125(CA125),carbohydrate antigen 15-3(CA153),carbohydrate antigen 50(CA50),carbohydrate antigen 19-9(CA19-9),cytokeratin 19 fragment(CYFRA21-1) and C-reactive protein(CRP) were measured in 199 patients with lung adenocarcinoma.Logistic regression model was used to analyze the correlation of clinical parameters with serum markers.Results There were no significant differences in serum marker levels between patients with left and right side of lung cancer(P>0.05).The gender,age and TNM stage of the patient were not correlated with CEA level(P>0.05).CA153,CA125,CA50,CA19-9,CYFRA21-1,CRP levels were correlated with TNM staging(P<0.05).CYFRA21-1 and CRP levels were correlated with gender(P<0.05).Conclusion The serum CYFRA21-1 and CRP levels of female lung adenocarcinoma patients was higher than those of male patients.Patients with high serum levels of CA-153,CA-125,CA-50,CA-19-9,CYFRA21-1 and CRP have higher TNM stages of lung adenocarcinoma.
引文
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[19]刘传玲,张晓东.左右半结肠癌的差异及临床治疗理念[J].中国肿瘤临床,2016,43(18):787-791.
[20]徐天成,吴晓亮,裴丽霞,等.肺与大肠相表里的微生态学解释[J].中国微生态学杂志,2018(1):100-103.
[2]张宁,张家合,刘理礼,等.原发性肺癌521例临床特点分析[J].现代肿瘤医学,2013,21(10):2246-2248.
[3]支修益,石远凯,于金明.中国原发性肺癌诊疗规范(2015年版)[J].中华肿瘤杂志,2015,37(1):67-78.
[4]杨万顺.肿瘤标志物联合C反应蛋白在肺癌诊断中的价值[J].广东微量元素科学,2016,23(1):51-53.
[5]李林,王迪进,万轲,等.CEA、CA125等肿瘤标志物联合检测在肺癌诊断中的价值[J].实用癌症杂志,2015(12):1789-1792.
[6]刘琳娟,张书耕,张青云,等.肿瘤标志物联合检测在肺癌诊断中价值[J].中华实用诊断与治疗杂志,2015,29(2):177-179.
[7]沙杰,范理宏.miRNA-146b-3p在早期非小细胞肺癌中的诊断价值[J].同济大学学报(医学版),2018,39(2):73-78.
[8]王鹏.非小细胞肺癌手术前后肿瘤标志物变化的临床意义[D].西宁:青海大学,2016.
[9]孙红梅,陈文彰,燕丽香,等.4种肿瘤标志物在肺癌病理分型、分期中的临床价值[J].现代肿瘤医学,2014(9):2105-2109.
[10]GAO Y,SONG P P,LI H,et al.Elevated serum CEA levels are associated with the explosive progression of lung adenocarcinoma harboring EGFR mutations[J].BMC Cancer,2017,17(1):484.
[11]吕艳玲,袁冬梅,金淑贤,等.非小细胞肺癌患者癌胚抗原、C反应蛋白表达水平与预后的关系[J].中华肺部疾病杂志(电子版),2016,9(2):140-144.
[12]徐莉,朱晔涵.血清CA125和IL-10水平测定在评估晚期非小细胞肺癌患者预后中的价值[J].临床肺科杂志,2016,21(4):616-618.
[13]YING L,WU J,ZHANG D,et al.Preoperative serum CA125 is an independent predictor for prognosis in operable patients with non-small cell lung cancer[J].Neoplasma,2015,62(4):602-609.
[14]DIEZ M,GOMEZ A,HERNANDO F,et al.Serum CEA,CA125,and SCC antigens and tumor recurrence in resectable non-small cell lung cancer[J].Int J Biol Markers,1995,10(1):5-10.
[15]ABDALLAH A,BELAL M,BASTAWISY A E,GAAFAR R.Plasma CA 19-9 in Advanced Non-Small Cell Lung Cancer[J].Cancer Clin Oncol,2013,2(2):11-18.
[16]SATO Y,FUJIMOTO D,UEHARA K,et al.The prognostic value of serum CA 19-9 for patients with advanced lung adenocarcinoma[J].BMC Cancer,2016,16(1):890.
[17]倪军.常见肺癌血清肿瘤标志物在具有肺癌高危因素患者中的临床意义[D].北京:协和医学院中国医学科学院,2015:1-55.
[18]石远凯,孙燕,于金明,等.中国晚期原发性肺癌诊治专家共识(2016年版)[J].中国肺癌杂志,2016,19(1):1-15.
[19]刘传玲,张晓东.左右半结肠癌的差异及临床治疗理念[J].中国肿瘤临床,2016,43(18):787-791.
[20]徐天成,吴晓亮,裴丽霞,等.肺与大肠相表里的微生态学解释[J].中国微生态学杂志,2018(1):100-103.