60例肺癌并上腔静脉综合征患者血液中D-二聚体、CEA、CYFRA21-1水平变化及意义
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摘要
[目的]探讨肺癌并上腔静脉综合征(superior vena cava syndrome,SVCS)患者血浆D-二聚体、血清CEA、CYFRA21-1水平变化及意义。[方法 ]60例肺癌合并SVCS的Ⅲ、Ⅳ期患者为实验组,60例未合并SVCS的Ⅲ、Ⅳ期患者作为对照组。给予两组患者三维适形放疗联合化疗治疗,检测血D-二聚体水平、血清CEA及CYFRA21-1水平。[结果]实验组患者治疗后的血D-二聚体、CEA、CYFRA21-1水平均显著低于治疗前(P<0.05),差异有统计学意义,与对照组比较无显著差异;治疗前实验组患者的D-二聚体、CEA、CYFRA21-1水平均显著高于对照组(P<0.05)。实验组缓解患者的D-二聚体、CEA、CYFRA21-1水平均显著低于未缓解患者(P<0.05)。[结论]肺癌并SVCS患者血液中具有较高的D-二聚体、CEA、CYFRA21-1水平,三维适形放疗联合化疗治疗能够有效降低其水平,改善患者预后。
[Purpose] To investigate the changes and significances of level of D-dimer in plasma and serum levels of carcinoembryonic antigen(CEA)and cytokeratin 19 fragment 21-1(CYFRA21-1)in patients with lung cancer complicated with superior vena cava syndrome(SVCS). [Methods]All 120 patients with lung cancer stage Ⅲ/Ⅳ were recruited in the study. Sixty cases with SVCS as the experimental group,and 60 cases without SCVS as control group received three-dimensional conformal radiation therapy combined with chemotherapy. The level of D-dimer in plasma and serum levels of CEA,CYFRA21-1 were detected in all patients. [Results] The levels of D-dimer,CEA and CYFRA21-1 in the experimental group after treatment were significantly lower than those before treatment(P <0.05),but no significant difference were found compared with control group. While before treatment,the levels of D-dimer,CEA and CYFRA21-1 in the experimental group were significantly higher than those in control group(P<0.05).In the experimental group,the levels of D-dimer,CEA and CYFRA21-1 in patients with CR +PR were significantly lower than those in patients with SD +PD(P <0.05). [Conclusion] Lung cancer patients complicated with SVCS have high levels of D-dimer,CEA and CYFRA21-1 in blood. Three-dimensional conformal radiation therapy combined with chemotherapy might effectively reduce their levels and improve patients' prognosis.
[Purpose] To investigate the changes and significances of level of D-dimer in plasma and serum levels of carcinoembryonic antigen(CEA)and cytokeratin 19 fragment 21-1(CYFRA21-1)in patients with lung cancer complicated with superior vena cava syndrome(SVCS). [Methods]All 120 patients with lung cancer stage Ⅲ/Ⅳ were recruited in the study. Sixty cases with SVCS as the experimental group,and 60 cases without SCVS as control group received three-dimensional conformal radiation therapy combined with chemotherapy. The level of D-dimer in plasma and serum levels of CEA,CYFRA21-1 were detected in all patients. [Results] The levels of D-dimer,CEA and CYFRA21-1 in the experimental group after treatment were significantly lower than those before treatment(P <0.05),but no significant difference were found compared with control group. While before treatment,the levels of D-dimer,CEA and CYFRA21-1 in the experimental group were significantly higher than those in control group(P<0.05).In the experimental group,the levels of D-dimer,CEA and CYFRA21-1 in patients with CR +PR were significantly lower than those in patients with SD +PD(P <0.05). [Conclusion] Lung cancer patients complicated with SVCS have high levels of D-dimer,CEA and CYFRA21-1 in blood. Three-dimensional conformal radiation therapy combined with chemotherapy might effectively reduce their levels and improve patients' prognosis.
引文
[1]Wei B,Han B.The application of combined the D-dimer and tumor markers in the diagnosis of lung cancer[J].The Journal of Chinese Misdiagnosis,2012,12(9):2061.[魏波,韩波.联合检测D-二聚体和肿瘤标志物在肺癌诊断中的应用[J].中国误诊学杂志,2012,12(9):2061.]
[2]Ma XH,Ma JJ,Dai XG,et al.Efficacy of three-dimensional conformal radiotherapy combined with chemotherapy for malignant superior vena cava syndrome[J].The Practical Journal of Cancer,2012,27(6):635-637.[马旭辉,马晶洁,戴新国,等.三维适形放疗联合化疗对恶性肿瘤致上腔静脉综合征的疗效分析[J].实用癌症杂志,2012,27(6):635-637.]
[3]Zheng J.The analysis on efficacy of radiation therapy for superior vena cava syndrome in 26 cases[J].Clinical Medicine,2012,32(9):30-31.[郑杰.上腔静脉综合征26例放射治疗的疗效分析[J].临床医学,2012,32(9):30-31.]
[4]Deng MY,Wang GH,Liu YM,et al.The study of relationship D-dimer and fibrinogen with lung cancer staging and prognosis[J].Journal of Clinical Pulmonary Medicine,2011,16(8):1230-1232.[邓美玉,王光辉,刘勇谋,等.D-二聚体、纤维蛋白原与肺癌的分期及预后的关系研究[J].临床肺科杂志,2011,16(8):1230-1232.]
[5]Bai XX,Zhang YP.Research status of the detection of lung tumor marker[J].Journal of Clinical Pulmonary Medicine,2011,16(2):259-260.[白晓雪,张艳蓓.肺肿瘤标志物检测的研究现状[J].临床肺科杂志,2011,16(2):259-260.]
[6]Zhao WJ,Zhou HX,Cao Q,et al.The significance of plasma D-dimer and endotoxin levels for judging the prognosis of patients with non-small cell lung cancer[J].Chinese Journal of Clinical Laboratory Science,2012,30(5):340-342.[赵文杰,周洪兴,曹琦,等.血浆D-二聚体与内毒素水平对判断非小细胞肺癌患者预后的意义[J].临床检验杂志,2012,30(5):340-342.]
[7]Xu F,Wu YW,Zhang B.Diagnostic value of the detection of serum IGF-1,CEA,CYFRA21-1 and NSE to lung cancer[J].Chinese Journal of Nuclear Medicine,2011,31(3):205-209.[许峰,吴翼伟,章斌.血清IGF-I及CEA、CYFRA21-1、NSE联合检测在肺癌诊治中的价值[J].中华核医学杂志,2011,31(3):205-209.]
[8]Hang ZQ,Zheng MF,Huang JH.The detection and clinical value of carcinoembryonic antigen and cytokeratin fragment 19 of patients with lung cancer[J].Chinese Journal of Oncology,2011,33(11):847-849.[杭志强,郑明峰,黄捷辉.肺癌患者血清中癌胚抗原和细胞角蛋白片段19的检测与临床价值[J].中华肿瘤杂志,2011,33(11):847-849.]
[9]Feng XH,Sun YF,Xia AP.The clinical significance of the combined determination of NSE,CYFRA21-1,PDGFBB and D-D in patients with lung cancer[J].Laboratory Medicine,2011,26(11):741-745.[冯晓鸿,孙业富,夏爱萍.联合测定NSE、CYFRA21-1、PDGFBB和D-D在肺癌患者中的临床意义[J].检验医学,2011,26(11):741-745.]
[10]Lu GJ,Yu LK,Zhang Y.Diagnostic value of the detection of serum CEA,NSE,SCC-Ag,CYFRA21-1 to lung cancer[J].Journal of Clinical Pulmonary Medicine,2011,16(8):1282-1283.[陆国军,于力克,张宇.血清CEA、NSE、SCCAg、CYFRA21-1联合检测对肺癌的诊断价值[J].临床肺科杂志,2011,16(8):1282-1283.]
[2]Ma XH,Ma JJ,Dai XG,et al.Efficacy of three-dimensional conformal radiotherapy combined with chemotherapy for malignant superior vena cava syndrome[J].The Practical Journal of Cancer,2012,27(6):635-637.[马旭辉,马晶洁,戴新国,等.三维适形放疗联合化疗对恶性肿瘤致上腔静脉综合征的疗效分析[J].实用癌症杂志,2012,27(6):635-637.]
[3]Zheng J.The analysis on efficacy of radiation therapy for superior vena cava syndrome in 26 cases[J].Clinical Medicine,2012,32(9):30-31.[郑杰.上腔静脉综合征26例放射治疗的疗效分析[J].临床医学,2012,32(9):30-31.]
[4]Deng MY,Wang GH,Liu YM,et al.The study of relationship D-dimer and fibrinogen with lung cancer staging and prognosis[J].Journal of Clinical Pulmonary Medicine,2011,16(8):1230-1232.[邓美玉,王光辉,刘勇谋,等.D-二聚体、纤维蛋白原与肺癌的分期及预后的关系研究[J].临床肺科杂志,2011,16(8):1230-1232.]
[5]Bai XX,Zhang YP.Research status of the detection of lung tumor marker[J].Journal of Clinical Pulmonary Medicine,2011,16(2):259-260.[白晓雪,张艳蓓.肺肿瘤标志物检测的研究现状[J].临床肺科杂志,2011,16(2):259-260.]
[6]Zhao WJ,Zhou HX,Cao Q,et al.The significance of plasma D-dimer and endotoxin levels for judging the prognosis of patients with non-small cell lung cancer[J].Chinese Journal of Clinical Laboratory Science,2012,30(5):340-342.[赵文杰,周洪兴,曹琦,等.血浆D-二聚体与内毒素水平对判断非小细胞肺癌患者预后的意义[J].临床检验杂志,2012,30(5):340-342.]
[7]Xu F,Wu YW,Zhang B.Diagnostic value of the detection of serum IGF-1,CEA,CYFRA21-1 and NSE to lung cancer[J].Chinese Journal of Nuclear Medicine,2011,31(3):205-209.[许峰,吴翼伟,章斌.血清IGF-I及CEA、CYFRA21-1、NSE联合检测在肺癌诊治中的价值[J].中华核医学杂志,2011,31(3):205-209.]
[8]Hang ZQ,Zheng MF,Huang JH.The detection and clinical value of carcinoembryonic antigen and cytokeratin fragment 19 of patients with lung cancer[J].Chinese Journal of Oncology,2011,33(11):847-849.[杭志强,郑明峰,黄捷辉.肺癌患者血清中癌胚抗原和细胞角蛋白片段19的检测与临床价值[J].中华肿瘤杂志,2011,33(11):847-849.]
[9]Feng XH,Sun YF,Xia AP.The clinical significance of the combined determination of NSE,CYFRA21-1,PDGFBB and D-D in patients with lung cancer[J].Laboratory Medicine,2011,26(11):741-745.[冯晓鸿,孙业富,夏爱萍.联合测定NSE、CYFRA21-1、PDGFBB和D-D在肺癌患者中的临床意义[J].检验医学,2011,26(11):741-745.]
[10]Lu GJ,Yu LK,Zhang Y.Diagnostic value of the detection of serum CEA,NSE,SCC-Ag,CYFRA21-1 to lung cancer[J].Journal of Clinical Pulmonary Medicine,2011,16(8):1282-1283.[陆国军,于力克,张宇.血清CEA、NSE、SCCAg、CYFRA21-1联合检测对肺癌的诊断价值[J].临床肺科杂志,2011,16(8):1282-1283.]