肺腺癌患者术前血清肿瘤标志物与微乳头、实体成分的关联研究  

Study of the associations between preoperative serum tumor markers and the micropapillary and solid components in patients with lung adenocarcinoma

作　　者：李志华[1] 潘相龙 吴卫兵[1] 陈亮[1] 何志成[1] LI Zhihua;PAN Xianglong;WU Weibing;CHEN Liang;HE Zhicheng(Department of Thoracic Surgery,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院胸外科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2022年第6期843-848,860,共7页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家自然科学基金(81972175);白求恩·爱惜康卓越外科基金(HZB-20190528-16)。

摘　　要：目的:本研究旨在分析肺腺癌患者术前血清肿瘤标志物与肺腺癌微乳头及实体成分的关联。方法:回顾性筛选2018年1月—2020年12月于南京医科大学第一附属医院胸外科就诊的浸润性肺腺癌患者,采集患者术前血清肿瘤标志物[癌胚抗原(carcinoembryonic antigen,CEA)、糖类抗原199(carbohydrate antigen 199,CA19-9)、糖类抗原724(carbohydrate antigen724,CA724)、神经元特异性烯醇化酶(neuron specific enolase,NSE)、甲胎蛋白(alpha fetoprotein,AFP)及细胞角蛋白21片段抗原(cytokeratin 21 fragment antigen,CYFRA21-1)]、病理亚型等信息。采用Student’s t-检验、卡方检验、Logistic回归等方法分析血清肿瘤标志物与微乳头、实体成分等临床病理特征的关联。结果:共纳入2159例肺腺癌患者,分别有291例及248例患者含有微乳头、实体成分。6种肿瘤标志物中,CEA及CYFRA21-1与肿瘤大小、淋巴结转移显著相关(P<0.001)。含实体成分的肺腺癌患者,其CEA(2.92 ng/mL vs.1.88 ng/mL,P<0.001)及CYFRA21-1(2.20 ng/mL vs.2.02 ng/mL,P<0.001)表达显著高于不含实体成分的患者。同样,CEA(2.59 ng/mL vs.1.92 ng/mL,P<0.001)及CYFRA21-1(2.15 ng/mL vs.2.03 ng/mL,P=0.009)在含微乳头成分肺腺癌中的表达显著高于不含微乳头成分者。单因素回归分析显示,性别、肿瘤大小、CEA及CYFRA21-1与微乳头及实体成分有关。多因素回归分析表明,CEA与实体(OR=2.87,95%CI:2.03~4.06,P<0.001)、微乳头(OR=2.36,95%CI:1.68~3.32,P<0.001)成分的关联仍然显著,而CYFRA21-1与微乳头、实体成分的关联不再具有统计学意义(P>0.05)。结论:肺腺癌患者术前血清CEA及CYFRA21-1表达与微乳头、实体成分有关,可能作为肺腺癌微乳头、实体成分的预测因子。Objective:This study aims to analyze the associations between preoperative serum tumor markers and the micropapillary and solid components in patients with lung adenocarcinoma.Methods:Patients with invasive lung adenocarcinoma who underwent treatment in our department from January 2018 to December 2020 were retrospectively screened.Preoperative serum tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA19-9),carbohydrate antigen 724(CA724),neuron specific enolase(NSE),alpha fetoprotein(AFP)and cytokeratin 21 fragment antigen(CYFRA21-1)],histopathological subtypes and other characteristics were collected.Student’s t-test,χ2test,logistic regression analyses were used to evaluate the relations between serum tumor markers and the micropapillary and solid components,as well as other clinicopathological characteristics.Results:A total of2159 lung adenocarcinoma patients were enrolled in the current study.There were 291 and 248 patients harboring micropapillary and solid components,respectively.Among these six tumor markers,CEA and CYFRA21-1 levels were significantly associated with tumor size and lymph node metastasis(P<0.001).Patients with solid components had a higher CEA(2.92 ng/mL vs.1.88 ng/mL,P<0.001)and CYFRA21-1(2.20 ng/mL vs.2.02 ng/mL,P<0.001)level than those absence of solid components.Similarly,the expression levels of CEA(2.59 ng/mL vs.1.92 ng/mL,P<0.001)and CYFRA21-1(2.15 ng/mL vs.2.03 ng/mL,P=0.009)in patients with micropapillary components were significantly higher than that in patients without micropapillary components.The univariate regression analysis indicated that gender,tumor size,CEA and CYFRA21-1 levels were significantly associated with solid and micropapillary components.However,the multivariate analysis showed that associations between CEA and solid(OR=2.87,95%CI:2.03-4.06,P<0.001),and micropapillary(OR=2.36,95%CI:1.68-3.32,P<0.001)components were still significant,while the associations between CYFRA21-1and solid or micropapillary components were not significant anymore(

关 键 词：肺腺癌 血清肿瘤标志物 微乳头成分 实体成分 CEA CYFRA21-1 

分 类 号：R734.2[医药卫生—肿瘤]