NSE对治疗前非小细胞肺癌患者发生脑部转移与生存状况中的预测效果  

Prediction effect of NSE to brain mestastasis in patients with non-small cell lung cancer before treatment and living condition

作　　者：李伟[1] 

机构地区：[1]安阳钢铁集团公司职工总医院检验科,河南安阳455004

出　　处：《医学检验与临床》2017年第4期12-15,共4页Medical Laboratory Science and Clinics

摘　　要：目的：分析治疗前血清神经元特异性烯醇化酶（Neuron specific enolase,NSE）水平与非小细胞肺癌（non-small cell lung cancer,NSCLC）患者发生脑转移及生存状况的关系.方法：选取2011年6月~2012年12月于我院治疗的148例NSCLC患者为研究对象,检测患者治疗前NSE、癌胚抗原（carcino-embryonic antigen CEA）及细胞角蛋白21-1片段（cyfra21-1）水平,并收集患者年龄、 病理分型、 原发肿瘤大小等临床资料.采用Kaplan-Meier法计算患者的生存状况,Logistic多因素分析NSCLC患者发生脑转移的危险因素.结果：148例NSCLC患者中共35例患者发生了脑转移,转移率为23.65%.脑转移患者治疗前的平均血清NSE水平为（36.1±21.3）ng/mL,显著高于无脑转移组患者（14.6±4.52）ng/mL,差异有统计学意义（P〈0.05）.脑转移患者的1年、2年生存率分别为25.71%、8.57%,无脑转移组患者的1年、2年生存率分别为58.41%、23.01%,差异有统计学意义（P〈0.05）.NSE≥17.0ng/mL组1年、2年生存率分别为43.64%、9.09%,NSE〈17.0ng/mL组1年、2年生存率分别为1.29%、19.36%,差异有统计学意义（P〈0.05）.Logistic多因素回归分析结果显示：区域淋巴结转移、 远处转移（除脑部外）、NSE及CEA升高是发生脑转移的危险因素.结论：治疗前血清NSE水平升高是NSCLC患者发生脑转移的危险因素,NSE≥17.0ng/mL的NSCLC患者预后较差.Objective： This study aims to analyze the value of serum neuron-specific enolase （Neuron specific enolase, NSE） in predicting brain metastasis and survival in patients with non-small cell lung cancer （non-small dell lung cancer, NSCLC） . Methods： 148NSCLC patients, from June 2011 to December 2012 in our hospital, were selected for the study. NSE, CEA （carcino-embryonic antigen CEA） and cytokeratin fragment 21-1 （cyfra21 -1） levels were tested before treatment.Patients＇ age, pathological type, primary tumor size and other clinical datawere collect＆ Kaplan-Meier method was used to calculate the patient＇s rate of survival, and risk factors related to brain metastases in NSCLC patients were analyzed by Logistic multivariate analysis.Results： In 148 NSCLC patients, 35 cases occurred brain metastases, and the metastasis rate was 23.65%. Mean serum NSE level in patients with brain metastases before treatment was （36.1 ± 21.3） ng / mL, and was significantly higher than that of patients without brain metastasis group （14.6 ± 4.52） ng / mL. The difference was statistically significant （P 〈0.05） . 1-year, 2-year survival rates in patients with brain metastases were 25.71%, 8.57%.l-year, 2-year survival rates in patients without brain metastasis were 58.41%, 23.01%, and the difference was statistically significant （P〈0,05） . In NSE≥l7.0ng/mL group, 1--year, 2-year survival rates were 43.64%, 9.09%. In NSE 〈17.0ng/mL group, 1-year, 2-year survival rates of patients were 1.29%, 19.36%. The difference was statistically significant （P〈0.05） . Logistic regression analysis showed that regional lymph node metastasis, distant metastasis （except outside the brain） , higher level of NSE and CEA wererisk factors for brain metastases. Conclusion： The higher pre-treatment serum levels of NSE is a risk factor for NSCLC patients with brain metastases, and NSE ≥ 17.0rig / mL indicate apoor prognosis in NSCLC patients.

关 键 词：非小细胞肺癌 脑转移 神经元特异性烯醇化酶 生存率 

分 类 号：R734.2[医药卫生—肿瘤]