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    外周血肿瘤标志物水平与肺癌患者化疗疗效的相关性研究

    Correlation between the levels of tumor markers in the peripheral blood and the chemotherapy efficacy of patients with lung cancer

    • 摘要: 目的观察肺癌患者外周血肿瘤标志物癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段(CYFRA 21-1)及胃泌素释放肽前体(ProGRP)表达水平在化疗前后的变化,探讨其在评价肺癌患者近期化疗疗效中的临床应用价值。方法随机选取80例肺癌患者,均接受至少2个周期的化疗。所有入组患者在化疗前后均检测其外周血中CEA、NSE、CYFRA 21-1及ProGRP表达水平,并进一步探讨其与临床病理特征及化疗疗效、预后的相关性。结果根据化疗前留取的肿瘤标志物基线分析,肺鳞癌组患者外周血中CYFRA 21-1表达水平高于其他组,差异具有统计学意义(P<0.05),肺腺癌组患者CEA表达较其他患者高,但无统计学差异(P>0.05),同时小细胞肺癌组中NSE及ProGRP均较非小细胞肺癌组高(P<0.05)。按照化疗后肿瘤标志物水平较化疗前升高与降低分别分为升高组及降低组,结果显示肿瘤标志物降低组中的患者化疗疗效较升高组好。进一步分析发现化疗后肿瘤标志物水平较低组预示患者预后结果较好,结果均具有统计学差异(P<0.05)。结论通过检测外周血内肿瘤标志物CEA、NSE、CYFRA 21-1及ProGRP水平对诊断肺癌肿瘤的病理类型具有一定的指导意义,且在评价肺癌患者的化疗疗效及预后方面也有一定的临床价值。

       

      Abstract: ObjectiveTo investigate the levels of tumor markers carcino-embryonic antigen (CEA), neuron-specific enolase (NSE), cytokeratin-19 fragment (CYFRA21-1) and pro-gastrin-releasing peptide (ProGRP) in the peripheral blood of lung cancer patients before and after chemotherapy and their correlations with recent efficacy of chemotherapy. MethodsA total of 80 lung cancer patients were randomly selected who received chemotherapy for at least two durations. Their levels of CEA, NSE, CYFRA21-1 and ProGRP in the peripheral blood were detected before and after chemotherapy. Their relationship with clinical characteristics, chemotherapy efficacy, and prognosis was discussed. ResultsThe squamous cell carcinoma group showed a remarkably higher level of serum CYFRA 21-1 than other group (P<0.05). Although the level of CEA in the adenocarcinoma group was higher than those in other groups, there was no statistical difference between each group (P>0.05). Meanwhile, the small cell lung cancer group produced significantly higher levels of NSE and ProGRP than the NSCLC group (P<0.05).Remarkably better clinical efficacy and prognosis were found in patients with decreased levels of tumor markers, compared with those with increased levels (P<0.05). ConclusionsThe levels of CEA, NSE, CYFRA21-1 and ProGRP can be used as the important indicators for evaluating the efficacy of lung cancer chemotherapy with specific pathological types.

       

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