血清肿瘤标记物联合动态检测在评估中医辅助治疗中晚期肺癌疗效中的价值  

The value of serum tumor markers plus dynamic detection in evaluating the efficacy of TCM adjuvant treatment of advanced lung cancer

作　　者：安宁 解学芳[2] 纪铜镇 刘涛[4] AN Ning

机构地区：[1]日照市中心医院,山东日照276800 [2]日照市人民医院,山东日照276826 [3]日照市结核病防治所,山东日照276800 [4]日照市中医医院,山东日照276800

出　　处：《中医临床研究》2022年第19期17-20,共4页Clinical Journal Of Chinese Medicine

摘　　要：目的:评价血清肿瘤标记物癌胚抗原(Carcino-Embryonic Antigen,CEA)、细胞角蛋白19片段抗原21-1(Cytokeratin 19 Fragment Antigen 21-1,CYFRA21-1)、神经元特异性烯醇化酶(Neuron Specific Enolase,NSE)联合动态检测在评估中医辅助治疗中晚期肺癌疗效中的临床应用价值。方法:选取90例中晚期肺癌患者为研究对象,随机分为观察组和对照组各45例,两组治疗前后均采用电化学发光法检测血清CEA、CYFRA21-1、NSE水平。对照组采用常规西医(手术、放化疗)治疗,观察组在西医治疗基础上辅助中医药治疗;比较两组患者治疗后血清CEA、CYFRA21-1、NSE水平变化及临床疗效差异;Spearman分析治疗后临床疗效与血清CEA、CYFRA21-1、NSE水平的相关性;绘制受试者工作特征曲线(Receiver Operating Characteristic Curve,ROC曲线),确定治疗后血清CEA、CYFRA21-1、NSE,预判中晚期肺癌发生事件的最佳临界值;Kaplan-Meier法及Log-rank检验生存分析,评估预后。结果:治疗后两组血清CEA、CYFRA21-1、NSE水平显著低于治疗前,且治疗后观察组血清CEA、CYFRA21-1、NSE水平显著低于对照组治疗后水平(均P<0.01);治疗后观察组临床治疗总有效率显著高于对照组(χ^(2)=5.874,P=0.015);治疗后临床疗效与血清CEA、CYFRA21-1、NSE水平具有显著相关性(P<0.05);治疗后血清CEA、CYFRA21-1、NSE预判中晚期肺癌发生事件的最佳临界值分别为20.65 ng/mL、16.34 ng/mL、36.12 ng/mL;治疗后观察组两年内无事件生存发生率显著高于对照组(χ^(2)=5.908,P=0.015)。结论:中医辅助治疗中晚期肺癌可显著提高临床疗效,提高无事件生存率;血清肿瘤标记物可作为评价临床疗效的客观指标。Objective:To evaluate serum tumor markers CEA,CYFRA21-1,NSE plus dynamic detection in the evaluation of the clinical application value of TCM adjuvant therapy in the treatment of advanced lung cancer.Methods:Ninety patients with advanced lung cancer were selected as the research objects,and they were randomly divided into the observation group and the control group with 45 cases in each.The electrochemiluminescence method was used to detect the serum CEA,CYFRA21-1,and NSE levels before and after treatment in both groups.The control group was treated by conventional Western medicine(surgery,radiotherapy and chemotherapy),and the observation group was treated with TCM plus Western medicine;the changes in serum CEA,CYFRA21-1,NSE levels and differences in clinical efficacy were compared between the two groups after treatment.Spearman was used to analyze the correlation between clinical efficacy and serum CEA,CYFRA21-1 and NSE levels after treatment.The receiver operating characteristic curve(ROC curve)was drawn to determine the best cut-off value for serum CEA,CYFRA21-1,and NSE to predict the occurrence of intermediate and advanced lung cancer after treatment.The prognosis was assessed by Kaplan-Meier method and Log-rank test for a survival analysis.Results:After treatment,the serum levels of CEA,CYFRA21-1,and NSE in the two groups were significantly lower than those before treatment,and the serum levels of CEA,CYFRA21-1,and NSE in the observation group after treatment were significantly lower than those in the control group(all P<0.01).The total efficiency of clinical treatment in the observation group was significantly higher than that in the control group(χ^(2)=5.874,P=0.015);the clinical efficacy after treatment was significantly correlated with serum CEA,CYFRA21-1,and NSE levels(P<0.05).After treatment,the best cut-off values of serum CEA,CYFRA21-1,and NSE for predicting the occurrence of intermediate and advanced lung cancer events were 20.65 ng/mL,16.34 ng/mL and 36.12 ng/mL.After treatment,the observation gr

关 键 词：肺癌 中晚期 中医药 血清肿瘤标记物 

分 类 号：R73[医药卫生—肿瘤]