血清CEA、CYFRA21-1表达与晚期NSCLC患者化疗效果的关系及疗效影响因素分析
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摘要
目的探讨晚期非小细胞肺癌(NSCLC)患者化疗前后血清癌胚抗原(CEA)、细胞角质蛋白19片段(CYFRA21-1)的水平及其与化疗效果的关系,并对化疗效果的影响因素进行分析。方法回顾性分析120例接受化疗的晚期NSCLC患者的病历资料,观察分析NSCLC患者的化疗效果,检测化疗前后NSCLC患者的血清CEA、CYFRA21-1水平,并对NSCLC患者化疗效果的影响因素进行分析。结果 120例NSCLC患者中,化效有效者68例(化疗有效组);化疗无效者52例(化疗无效组)。化疗前和化疗后,化疗有效组患者的血清CEA、CYFRA21-1水平均低于化疗无效组患者(P﹤0.05)。单因素分析结果显示:化疗有效组TNM分期为Ⅳ期的NSCLC患者所占比例明显低于化疗无效组(P﹤0.01),化疗有效组CEA≤5.0 ng/ml、CYFRA21-1≤5.0 ng/ml的NSCLC患者所占比例均高于化疗无效组(P﹤0.05);多因素分析结果显示,TNM分期为Ⅳ期、CEA﹥5.0 ng/ml、CYFRA21-1﹥5.0 ng/ml为晚期NSCLC患者化疗效果的独立危险因素(P﹤0.05)。结论化疗前,血清CEA、CY-FRA21-1高水平是NSCLC患者化疗效果的独立危险因素,在化疗前进行血清CEA、CYFRA21-1水平检测对预测和评估化疗效果具有重要意义。
Objective To investigate the correlation between serum carcinoembryonic antigen(CEA) and cyto-keratin 19 fragment 21-1(CYFRA21-1) levels in patients with NSCLC before and after chemotherapy and its effect on chemotherapy, and to analyze the influencing factors of the effect of chemotherapy. Method Retrospective analysis regarding the medical records of 120 patients with advanced NSCLC who received chemotherapy was performed, the therapeutic effects in these patients were observed, and the levels of serum CEA and CYFRA21-1 in NSCLC patients before and after chemotherapy were detected, in addition the factors influencing the effect of chemotherapy were analyzed. Result Among 120 patients with NSCLC, 68 patients were responders(response group), while no response was noted in 52(no response group). Before and after chemotherapy, the serum levels of CEA and CYFRA21-1 in the response group were lower than those in the no response group(P<0.05). Univariate analysis showed that in the response group, the proportion of TNM patients in stage IV was significantly lower than that in no response group(P<0.01), and the proportion of patients with CEA≤5.0 ng/ml and CYFRA21-1≤5.0 ng/ml in the response group was higher than that in the no response group(P<0.05); multivariate analysis indicated that TNM stage IV, CEA>5.0 ng/ml, and CYFRA21-1>5.0 ng/ml were independent risk factors for the effect of chemotherapy in patients with advanced NSCLC(P<0.05). Conclusion Before chemotherapy, high levels of serum CEA and CYFRA21-1 are independent risk factors for the effect of chemotherapy in patients with NSCLC, detection of serum CEA and CYFRA21-1 levels before chemotherapy is of great significance in predicting and evaluating the effect of chemotherapy.
Objective To investigate the correlation between serum carcinoembryonic antigen(CEA) and cyto-keratin 19 fragment 21-1(CYFRA21-1) levels in patients with NSCLC before and after chemotherapy and its effect on chemotherapy, and to analyze the influencing factors of the effect of chemotherapy. Method Retrospective analysis regarding the medical records of 120 patients with advanced NSCLC who received chemotherapy was performed, the therapeutic effects in these patients were observed, and the levels of serum CEA and CYFRA21-1 in NSCLC patients before and after chemotherapy were detected, in addition the factors influencing the effect of chemotherapy were analyzed. Result Among 120 patients with NSCLC, 68 patients were responders(response group), while no response was noted in 52(no response group). Before and after chemotherapy, the serum levels of CEA and CYFRA21-1 in the response group were lower than those in the no response group(P<0.05). Univariate analysis showed that in the response group, the proportion of TNM patients in stage IV was significantly lower than that in no response group(P<0.01), and the proportion of patients with CEA≤5.0 ng/ml and CYFRA21-1≤5.0 ng/ml in the response group was higher than that in the no response group(P<0.05); multivariate analysis indicated that TNM stage IV, CEA>5.0 ng/ml, and CYFRA21-1>5.0 ng/ml were independent risk factors for the effect of chemotherapy in patients with advanced NSCLC(P<0.05). Conclusion Before chemotherapy, high levels of serum CEA and CYFRA21-1 are independent risk factors for the effect of chemotherapy in patients with NSCLC, detection of serum CEA and CYFRA21-1 levels before chemotherapy is of great significance in predicting and evaluating the effect of chemotherapy.
引文
[1]邱慧兵,易铁男.不可手术局部晚期非小细胞肺癌患者预后的影响因素研究[J].实用心脑肺血管病杂志,2016,24(9):51-54.
[2]张敏,戈伟,陈明,等.三维适形放疗联合化疗同步治疗非小细胞肺癌晚期局部复发的近期疗效[J].实用癌症杂志,2016,31(2):242-245.
[3]尹竺晟,戈伟,罗卫,等.肿瘤标志物在非小细胞肺癌患者诊断中的价值[J].中国医药导报,2016,13(23):102-105.
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[6]丁香园.2015版美国国立综合癌症网络(NCCN)指南:非小细胞肺癌更新要点[J].实用心脑肺血管病杂志,2015,23(2):55.
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[8]王济东,颜学庆,王俊杰.早期肺癌局部非手术治疗的研究进展[J].癌症进展,2016,14(7):623-627.
[9]沈月,夏建洪,王珂,等.培美曲塞+顺铂方案同步放疗治疗局部晚期非鳞非小细胞肺癌的临床观察[J].东南大学学报(医学版),2017,36(6):912-915.
[10]杨欣,林冬梅.2015版WHO肺癌组织学分类变化及其临床意义[J].中国肺癌杂志,2016,19(6):332-336.
[11]彭胜祖,李晓,王云,等.术后辅助化疗对Ⅰ期非小细胞肺癌无瘤生存时间的影响[J].中国肺癌杂志,2017,20(7):485-489.
[12]Masuda T,Imai H,Kuwako T,et al.Efficacy of platinum combination chemotherapy after first-line gefitinib treatment in non-small cell lung cancer patients harboring sensitive EGFR mutations[J].Clin Transl Oncol,2015,17(9):702-709.
[13]张程,张梅,任凤华,等.自体细胞治疗技术联合化疗对非小细胞肺癌患者T细胞亚群及胞内细胞因子水平的影响[J].中国老年学杂志,2017,37(12):2970-2971.
[14]辛文秀,童莹慧,孔思思,等.2014~2016年杭州地区11家医院肺癌患者铂类药物的应用分析[J].中国药师,2018,21(7):1221-1223.
[15]王直,陈其亮,李军孝,等.长春瑞滨联合顺铂化疗方案对非小细胞肺癌患者凝血功能的动态影响及意义[J].现代肿瘤医学,2016,24(10):1545-1549.
[16]黄晓龙,周晓芳,王增,等.培美曲塞联合顺铂不同途径治疗晚期非小细胞肺癌疗效观察[J].中国药师,2016,19(1):82-84.
[17]郑伟,康静波,温居一,等.恩度联合放化疗对老年Ⅲ期非小细胞肺癌的疗效和毒副反应[J].中国医师杂志,2016,18(9):1386-1388.
[18]李媛.晚期非小细胞肺癌患者放疗前后肿瘤标志物变化与近期疗效的临床分析[J].中国实验诊断学,2017,21(8):1335-1337.
[19]杜军华,乔洪源,尹宜发,等.血清CEA、CA125及Cyfra21-1水平对中晚期非小细胞肺癌患者预后的影响[J].肿瘤防治研究,2016,43(2):137-140.
[20]陈波,吴国荣,杨万勇,等.HE4、CYFRA21-1和TPS联合检测对非小细胞肺癌的早期诊断价值[J].实用医学杂志,2016,32(22):3721-3724.
[2]张敏,戈伟,陈明,等.三维适形放疗联合化疗同步治疗非小细胞肺癌晚期局部复发的近期疗效[J].实用癌症杂志,2016,31(2):242-245.
[3]尹竺晟,戈伟,罗卫,等.肿瘤标志物在非小细胞肺癌患者诊断中的价值[J].中国医药导报,2016,13(23):102-105.
[4]张红军,顾兴,刘伟,等.肿瘤标志物动态变化在肺癌疗效判断与随访中的意义[J/OL].中华肺部疾病杂志(电子版),2016,9(1):26-30[2018-04-03].http://zhfbjb.paperopen.com/oa/DArticle.aspx?type=view&id=201601007.
[5]季禹乔,孙明忠,朱晖,等.血清miRNA-21与肿瘤标志物CEA、CYFRA21-1、NSE对早期非小细胞肺癌的诊断价值[J].中国实验诊断学,2017,21(4):576-581.
[6]丁香园.2015版美国国立综合癌症网络(NCCN)指南:非小细胞肺癌更新要点[J].实用心脑肺血管病杂志,2015,23(2):55.
[7]杨旭,许光,雷振,等.RECIST1.1与WHO、RECIST1.0标准评价周边型肺癌疗效比较[J].中国医学影像学杂志,2012,20(5):355-358.
[8]王济东,颜学庆,王俊杰.早期肺癌局部非手术治疗的研究进展[J].癌症进展,2016,14(7):623-627.
[9]沈月,夏建洪,王珂,等.培美曲塞+顺铂方案同步放疗治疗局部晚期非鳞非小细胞肺癌的临床观察[J].东南大学学报(医学版),2017,36(6):912-915.
[10]杨欣,林冬梅.2015版WHO肺癌组织学分类变化及其临床意义[J].中国肺癌杂志,2016,19(6):332-336.
[11]彭胜祖,李晓,王云,等.术后辅助化疗对Ⅰ期非小细胞肺癌无瘤生存时间的影响[J].中国肺癌杂志,2017,20(7):485-489.
[12]Masuda T,Imai H,Kuwako T,et al.Efficacy of platinum combination chemotherapy after first-line gefitinib treatment in non-small cell lung cancer patients harboring sensitive EGFR mutations[J].Clin Transl Oncol,2015,17(9):702-709.
[13]张程,张梅,任凤华,等.自体细胞治疗技术联合化疗对非小细胞肺癌患者T细胞亚群及胞内细胞因子水平的影响[J].中国老年学杂志,2017,37(12):2970-2971.
[14]辛文秀,童莹慧,孔思思,等.2014~2016年杭州地区11家医院肺癌患者铂类药物的应用分析[J].中国药师,2018,21(7):1221-1223.
[15]王直,陈其亮,李军孝,等.长春瑞滨联合顺铂化疗方案对非小细胞肺癌患者凝血功能的动态影响及意义[J].现代肿瘤医学,2016,24(10):1545-1549.
[16]黄晓龙,周晓芳,王增,等.培美曲塞联合顺铂不同途径治疗晚期非小细胞肺癌疗效观察[J].中国药师,2016,19(1):82-84.
[17]郑伟,康静波,温居一,等.恩度联合放化疗对老年Ⅲ期非小细胞肺癌的疗效和毒副反应[J].中国医师杂志,2016,18(9):1386-1388.
[18]李媛.晚期非小细胞肺癌患者放疗前后肿瘤标志物变化与近期疗效的临床分析[J].中国实验诊断学,2017,21(8):1335-1337.
[19]杜军华,乔洪源,尹宜发,等.血清CEA、CA125及Cyfra21-1水平对中晚期非小细胞肺癌患者预后的影响[J].肿瘤防治研究,2016,43(2):137-140.
[20]陈波,吴国荣,杨万勇,等.HE4、CYFRA21-1和TPS联合检测对非小细胞肺癌的早期诊断价值[J].实用医学杂志,2016,32(22):3721-3724.