CEA、CYFRA21-1和CA125联合检测对非小细胞肺癌患者预后水平的评估价值  

The Value of the CEA,CA125 and CYFRA21-1 Joint Test in the Evaluation of the Prognosis of Patients with NSCLC

作　　者：王秋波[1] 施雪峰[1] 李巍[1] 惠超[1] 

机构地区：[1]辽宁省锦州市中心医院,121000

出　　处：《实用癌症杂志》2016年第10期1601-1604,共4页The Practical Journal of Cancer

摘　　要：目的观察非小细胞肺癌患者癌胚抗原(CEA)、血清细胞角蛋白19片段(CYFRA21-1)、糖类抗原125(CA125)水平在治疗前后的变化,探讨3项肿瘤标志物在评价非小细胞肺癌患者近期疗效和预后中的应用价值。方法选取80例晚期(Ⅲ期、Ⅳ期)非小细胞肺癌患者,均接受至少2个周期的顺铂+吉西他滨(GP)方案或紫杉醇+顺铂(PC)方案化疗。所有患者在化疗前后均检测其血清CEA、CYFRA21-1、CA125水平。结果腺癌患者CEA及CA125水平比鳞癌更高,而鳞癌CYFRA21-1水平比腺癌更高(P<0.05);Ⅳ期、外转移部位数量≥3的患者的CEA、CYFRA21-1、CA125水平均比Ⅲ期、外转移部位数量<3的患者高(P<0.05)。PR患者治疗后血清CEA、CYFRA21-1、CA125水平均比治疗前显著降低(P<0.05)。SD患者治疗前后3项肿瘤标志物水平差异不明显(P>0.05)。PD患者治疗后血清CEA、CYFRA21-1、CA125水平均显著增加(P<0.05)。CEA<15 ng/m L患者的平均PFS、OS均比CEA≥15 ng/m L的患者长(8.48±3.24 VS 5.04±2.03;17.11±5.13 VS 13.11±4.12);CYFRA21-1<5 ng/m L患者的平均PFS、OS均比CYFRA21-1≥5 ng/m L的患者长(8.92±3.47 VS 4.88±2.31;18.01±5.80 VS 13.44±4.75);CA125<30 U/m L患者的平均PFS、OS均比CA125≥30 U/m L的患者长(7.96±3.51 VS 5.91±2.75;16.47±6.52 VS 13.51±5.18),差异均有统计学意义(P<0.05)。结论血清CEA、CYFRA21-1、CA125水平对肿瘤分期及病理分型具有一定的参考意义,在评价晚期非小细胞肺癌患者的近期疗效和预后水平中具有较好的应用价值。Objective To observe the levels of carcinoembryonic antigen（CEA）,cytokeratin 19 fragment（CYFRA21-1） and carbohydrate antigen 125（CA125） before and after treatment in patients with non-small cell lung cancer（NSCLC）,and discusses the application value of the 3 tumor markers in the evaluation the short-term curative effect and prognosis of NSCLC.Methods 80 cases of advanced（stage Ⅲ,Ⅳ） NSCLC received at least 2 cycles of chemotherapy,cisplatin plus gemcitabine（GP） solutions or paclitaxel ＋ cisplatin（PC） solutions.Serum level of CEA,CA125 and CYFRA21-1 before and after chemotherapy were detected.Results CEA and CA125 levels in patients with adenocarcinoma were higher than squamous carcinoma,while CYFRA21-1 level of squamous cell carcinomas was higher than adenocarcinoma（P〈0.05）; The levels of CEA,CA125,CYFRA21-1 of the patients at stage Ⅳ,transfer number ≥3 were higher than the patients at stage Ⅲ and transfer amount〈3（P〈0.05）.The serum levels of CEA,CA125 and CYFRA21-1PR of PR patients after treatment was significantly lower than before treatment（P〈0.05）,There had no obvious difference in SD patients in level of the 3 tumor markers before and after treatment（P〉0.05）.The serum levels of the 3 tumor markers after treatment in PD patients significantly increased（P〈0.05）.The average PFS,OS of patients with CEA〈15 ng/mL was longer than the patients with CEA ≥15 ng/mL（8.48 ± 3.24 VS 5.04 ± 2.03; 17.11 ± 5.13 VS 13.11 ± 4.12）.The average PFS,OS of patients with CYFRA21-1〈5 ng/mL were longer than the patients with CYFRA21-1 ≥5 ng/mL（8.92 ± 3.47 VS 4.88 ± 2.31; 18.01 ± 5.80 VS 13.44 ± 4.75）.The average PFS,OS of patients with CA125〈30 u/mL were longer than the patients with CA125≥ 30 u/mL（7.96 ± 3.51 VS 5.91 ± 2.75; 16.47± 6.52 VS 13.51 ± 5.18）,the difference had statistical significance（P〈0.05）.Conclusion The serum levels of CEA,CA125 and CYFRA21-1 have certain significant for tumor staging and pathologic classif

关 键 词：非小细胞肺癌 肿瘤标志物 CEA CYFRA21-1 CA125 

分 类 号：R734.2[医药卫生—肿瘤]