血清角蛋白19片段在非小细胞肺癌患者术后的变化  

Changes of serum cytokeratin 19 fragment in postoperative patients with non-small cell lung cancer

作　　者：周永新[1] 王永武[1] 梅运清[1] 冯靖[1] 蔡建志[1] 孙益峰[1] 季强[1] 李大文[1] 

机构地区：[1]同济大学心肺血管疾病治疗中心

出　　处：《中华全科医师杂志》2007年第7期418-420,共3页Chinese Journal of General Practitioners

摘　　要：目的 探讨血清角蛋白19片段（CYFRA21—1）在非小细胞肺癌术后患者预后判断及随访监测中的价值。方法 回顾性分析我院207例非小细胞肺癌患者手术前后的CYFRA21—1结果，分析其与患者预后、复发和转移之间的关系。CYFRA21—1测定采用放射免疫分析方法。结果 所有患者平均随访37个月，治疗前总的阳性率为42．0％（87／207），其中腺癌34．6％（27／78），鳞癌为48．8％（60／123），两者间差异有统计学意义（Х^2=3．901，P〈0．05）。全组、Ⅱ期和Ⅲ期术前阳性患者的生存率均较阴性患者差（P〈0．05）。术后27个月随访中患者再次出现阳性或持续阳性对诊断是否有转移或复发的敏感性为52．9％（54／102），特异性为91．4％（96／105），而对于术前阳性的患者，则敏感性为81．3％（39／48），特异性84．6％（33／39）。结论 术前CYFRA21—1阳性非小细胞肺癌患者的预后差于阴性患者，CYFRA21—1可作为监测肿瘤是否有复发或转移的指标。Objective To study the clinical value of serum cytokeratin 19 fragment （CYFRA21-1） as a biomarker in evaluating its prognosis, monitoring and follow-up of the postoperative patients with non- small cell lung cancer （NSCLC）. Methods Serum CYFRA21-1 was determined by radioimmunoassay for 207 patients with NSCLC before and after surgical operation at Tongji Hospital, Shanghai. Relationship between serum CYFRA21-1 and the prognosis, recurrence and metastasis of lung cancer was analyzed retrospectively. Results The patients were followed-up for 37 months in average. Preoperative serum CYFRA21-1 was positive in 42. 0% （ 87/207 ） of all the cases, 48. 8% （ 60/123 ） of squamous cell carcinama and 34.6% （27/78） of adenocarcinoma, with statistical significance （Х^2=3. 901, P 〈 0. 05 ）. Survival for those with negative serum CYFRA21-1 was better than those with positive serum CYFRA21-1 （ P 〈 0. 05）, whether in all patients, or in patients at stage Ⅱ or stage Ⅲ. Sensitivity and specificity of serum CYFRA21-1 determination were 52.9% （54/102） and 91.4% （ 96/105 ）, respectively in those patients with recurrent positive or persistent positive of serum CYFRA21-1 during their 27-months follow-up after surgical operation. But, its sensitivity and specificity were 81.3% （ 39/48 ） and 84.6% （ 33/39 ）, respectively in those with positive serum CYFRA21-1 before surgical operation. Conclusions Prognosis in patients with positive serum CYFRA21-1 before surgical operation was poorer than those with negative serum CYFRA21-1 . Serum CYFRA21-1 can be used as a monitoring biomarker to evaluate recurrence or metastasis in patients with NSCLC.

关 键 词：肺肿瘤 癌 非小细胞肺 肿瘤标记 生物学 

分 类 号：R734.2[医药卫生—肿瘤]