鼻咽未分化癌患者放疗前后血清人细胞角蛋白21—1片段和癌胚抗原水平与预后的关系  

Prognostic value of CYFRA 21-1 and CEA in patients with undifferentiated nasopharyngeal carcinoma before and after radiotherapy

作　　者：朱婉琦[1] 孙新东[1] 谢鹏[1] 孔莉[1] 于金明[1] 

机构地区：[1]山东省肿瘤医院放射治疗四病区山东省医学科学院山东省肿瘤放射学重点实验室,济南250117

出　　处：《中华肿瘤杂志》2011年第5期367-370,共4页Chinese Journal of Oncology

摘　　要：目的 研究鼻咽未分化癌患者放疗前后血清人细胞角蛋白21-1片段（CFRA21-1）和癌胚抗原（CEA）水平与预后的关系.方法 回顾性分析2004年5月至2008年2月月随访资料完整、并经病理学确诊为无远处转移的62例鼻咽未分化癌患者的临床资料.所有患者均采用6MV X线调强放疗,分析放疗前后CYFBA21-1及CEA水平与患者预后的关系.结果 放疗前CYFRA21-1高水平组（〉2.49μg/L）患者的总生存率明显低于放疗前低水平组（≤2.49μg/L）,差异有统计学意义χ2=5.643,P=0.018）.N分期和T分期与患者无瘤生存时间有关（OR=4.054,P=0.001;OR=3.873,P=0.001）.在多因素分析中,无因素对复发及远处转移有明显的预测作用.CEA水平与患者预后无明显的相关性.结论 放疗前血清CYFRA21-1水平与鼻咽未分化癌患者的预后密切相关,放疗前CYFRA21-1高水平患者的预后较差.Objective The purpose of this study was to evaluate the potential of CYFRA 21-1 （CYFRA） and CEA as a prognostic marker in patients with undifferentiated nasopharyngeal carcinoma （ NPC）. Methods From March 2004 to February 2008, 62 patients with newly diagnosed, undifferentiated NPC were treated in our department. Their clinocopathological data were analyzed retrospectively. All patients received intensity-modulated radiotherapy using 6 MV X-rays, and serum CYFRA and CEA before and after radiotherapy were assayed. The association among the long-term follow-up results and age, sex, smoke, TNM stage, chemotherapy, CEA, CYFRA and the changes in any direction of serum CYFRA and CEA were determined. Results Patients with low pre-RT level （ ≤ 2. 49μg/L） of CYFRA had a significantly better overall survival （ OS） than patients with high level （ 〉 2. 49 μg/L,OR = 8. 555, P = 0.029）. N classification and T classification were positively associated with the prediction of progression free survival （ OR = 4. 054, P = 0. 001; OR = 3. 873, P = 0. 001 ）. But there was no significant association between the rest predictors （age, sex, CEA, post-RT CYFRA, chemotherapy and a radiation-induced decrease in serum markers） and the survival or recurrence rate by multivariate analysis. Conclusions The results of the present study show that pre-RT serum CYFRA level is a valuable factor for predicting long-term survival in patients with undifferentiated nasopharyngeal carcinoma. More aggressive treatment may be given to those patients with a high serum CYFRA level.

关 键 词：鼻咽肿瘤 人细胞角蛋白21—1片段 癌胚抗原 预后 

分 类 号：R739.63[医药卫生—肿瘤]