55例NSCLC患者围手术期血清肿瘤标志物的监测分析  

The monitoring analysis of perioperative tumor markers in non-small cell lung cancer of 55 cases

作　　者：夏杰[1] 于在诚[1] 

机构地区：[1]安徽医科大学第一附属医院普胸外科,合肥230022

出　　处：《安徽医科大学学报》2014年第7期1003-1007,共5页Acta Universitatis Medicinalis Anhui

基　　金：安徽省自然科学基金(编号:1208085QH159)

摘　　要：目的研究非小细胞肺癌(NSCLC)患者血清中细胞质胸苷激酶(TK1)、癌胚抗原(CEA)、鳞状细胞癌抗原(SCCAg)、细胞角蛋白19片段(CYFRA21-1)手术前后的表达水平变化及意义。方法选择行手术治疗的NSCLC患者55例作为肺癌组及同期普胸外科良性疾病患者29例作为对照组,用电化学发光法检测NSCLC患者手术前后及对照组血清中TK1、CEA、SCC-Ag、CYFRA21-1水平。分析两组血清4种肿瘤标志物(TM)水平变化。结果 1 NSCLC患者手术前血清TK1、CEA、SCC-Ag、CYFRA21-1水平及阳性率高于对照组水平(P<0.05)。2肺癌组NSCLC患者血清TK1术前、术后1周、术后1个月血清TK1水平变化呈先上升后下降趋势,差异无统计学意义(P>0.05);肺癌组NSCLC患者手术后1周及术后1个月血清CEA、SCC-Ag、CYFRA21-1水平明显低于术前水平(P<0.05);肺癌组NSCLC患者手术后1周、术后1个月血清CEA、CYFRA21-1水平与对照组相比,差异均无统计学意义(P>0.05),其中术后1周血清TK1、SCC-Ag水平与对照组相比差异有统计学意义(P<0.05),术后1个月血清TK1、SCC-Ag水平与对照组相比差异无统计学意义(P>0.05)。3肺腺癌术前血清TK1、CEA水平高于肺鳞癌(P<0.05)。4 NSCLC患者术前血清TK1、CYFRA21-1水平在女性患者中高于男性患者,差异有统计学意义(P<0.05),肺癌组NSCLC患者术前血清CEA、SCC-Ag水平与性别无显著相关性(P>0.05)。NSCLC患者术前血清TK1水平与肺癌分化程度呈负相关(P<0.05)。结论NSCLC围手术期相关TM水平的监测对NSCLC的诊断、鉴别诊断提供帮助,有助于从微观角度了解机体肿瘤负荷变化情况。NSCLC围手术期相关TM水平变化与手术疗效、组织类型存在一定相关性,TM TK1和CEA更适合于肺腺癌的评估,值得临床进一步推广应用。Objective To investigate the change and effect of operation on TK1,CEA, SCC-Ag and CYFRA21-1 level in non-small cell lung cancer patients. Methods From January 2013 to August 2013, 55 patients with NSCLC and 29 patients with benign lesions were recruited. The tumor indexes including TK1,CEA, SCC-Ag and CYFRA21-1 were measured by electrical chemiluminescence assay. Results ① Serum TK1, CEA, SCC-Ag and CYFRA21-1 level and the positive rates in NSCLC patients during preoperative period were higher than the benign disease control group （ P〈0. 05 ） . ② Serum TK1 level changes in NSCLC patients preoperative and postoperative one week and one month showed a trend of hump-shaped curve, there was no obvious statistically significant difference （ P〉0. 05 ） . Serum CEA , SCC-Ag and CYFRA21-1 level of postoperative one week and one month in NSCLC＆amp;nbsp;patients were significantly lower than the level before the operation （ P〈0. 05 ） . Serum CEA and CYFRA21-1 level of postoperative one week and one month in NSCLC patients showed no significant difference compared with benign disease control group （ P〉0. 05 ） , serum TK1 and SCC-Ag level of the postoperative one week showed statistically significant difference compared with benign disease control group （ P〈0. 05 ） , the postoperative one month level of serum TK1 and SCC-Ag showed no significant difference compared with benign disease control group （ P〉0. 05 ） .③The preoperative level of TK1 and CEA in adenocarcinoma were higher than that in squamous carcinoma （ P〈0. 05 ） . ④ The preoperative level of serum TK1 and CYFRA21-1 in female NSCLC patients were higher than male patients, the difference was statistically significant （ P 〈0. 05 ） , preoperative serum CEA and SCC-Ag level of NSCLC patients showed no obvious statistical correlation with gender （ P〉0. 05 ） . The preoperative level of serum TK1 in NSCLC patients negatively correlated with the degree of differentiation of lung cancer, the difference was stati

关 键 词：非小细胞肺癌 血清细胞质胸苷激酶 癌胚抗原 血 清鳞状细胞癌抗原 血清细胞角蛋白19片段 

分 类 号：R655.3[医药卫生—外科学] R734.2[医药卫生—临床医学]