血清癌胚抗原、甲胎蛋白、人附睾上皮分泌蛋白4水平与非小细胞肺癌患者预后的关系  

Relationship between serum carcinoembryonic antigen,alpha-fetoprotein,human epididymis protein 4 and prognosis of patients with non-small cell lung cancer

作　　者：吕珊珊 豆亚伟[1] 陈耀华[1] 田伟[1] 王宏涛[1] LYU Shanshan;DOU Yawei;CHEN Yaohua;TIAN Wei;WANG Hongtao(Department of Thoracic Surgery,Shaanxi Provincial People’s Hospital,Xi’an 710068,Shaanxi,China;Department of Cardiovascular Surgery,Xijing Hospital,the First Affiliated Hospital of Air Force Military Medical University,Xi’an 710032,Shaanxi,China)

机构地区：[1]陕西省人民医院胸外科,西安710068 [2]空军军医大学第一附属医院西京医院心血管外科,西安710032

出　　处：《癌症进展》2022年第16期1663-1666,共4页Oncology Progress

摘　　要：目的探讨血清癌胚抗原(CEA)、甲胎蛋白(AFP)、人附睾上皮分泌蛋白4(HE4)水平与非小细胞肺癌(NSCLC)患者预后的关系。方法选取153例NSCLC患者和177例健康体检者,分别作为观察组和对照组,检测两组受试者血清CEA、AFP、HE4水平,并分析其与NSCLC患者临床特征和预后的关系,采用Cox比例风险回归模型分析NSCLC患者预后的影响因素。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),分析CEA、AFP、HE4检测对NSCLC患者预后的预测价值。结果观察组患者血清CEA、AFP、HE4水平均明显高于对照组,差异均有统计学意义(P﹤0.01)。随访2年,153例NSCLC患者中,生存112例,死亡41例,病死率为26.80%。预后死亡NSCLC患者的血清CEA、AFP、HE4水平均明显高于预后生存患者,差异均有统计学意义(P﹤0.01)。临床分期为广泛期、有淋巴结转移、分化程度为低中分化、肿瘤直径≥2 cm、CEA水平升高、AFP水平升高、HE4水平升高均为NSCLC患者预后死亡的独立危险因素(P﹤0.05)。CEA+AFP+HE4检测预测NSCLC患者预后的AUC为0.917(95%CI:0.871~0.964),此时的灵敏度为0.954、特异度为0.969,均高于三者单独检测及CEA+HE4检测。结论NSCLC患者血清CEA、AFP、HE4水平均较高,三者与NSCLC患者的临床分期、淋巴结转移情况、分化程度、肿瘤直径均有关,三项指标水平升高不利于患者的预后。Objective To investigate the relationship between serum carcinoembryonic antigen,alpha-fetoprotein,human epididymis protein 4 and prognosis of patients with non-small cell lung cancer.Method A total of 153 NSCLC patients and 177 healthy subjects were selected as observation group and control group,respectively.The serum levels of CEA,AFP,and HE4 were detected in the two groups,and their relationship with the clinical characteristics and prognosis of NSCLC patients was analyzed.Cox proportional hazards regression model was used to analyze the prognostic factors of NSCLC patients.The receiver operating characteristic(ROC)curve was drawn,the area under the curve(AUC)was calculated,and the predictive value of CEA,AFP,and HE4 detection on the prognosis of NSCLC patients was analyzed.Result The serum levels of CEA,AFP and HE4 in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.01).During the 2-year follow-up,among the 153NSCLC patients,112 survived and 41 died,with fatality rate of 26.80%.The serum levels of CEA,AFP and HE4 in NSCLC patients with prognostic death were significantly higher than those in prognostic survival patients,and the differences were statistically significant(P<0.01).Extensive clinical stage,lymph node metastasis,low-to-moderate differentiation,tumor diameter≥2 cm,elevated CEA level,elevated AFP level,and elevated HE4 level were all independent risk factors for the prognosis and death of NSCLC patients(P<0.05).The AUC of CEA+AFP+HE4 detection for predicting the prognosis of NSCLC patients was 0.917(95%CI:0.871-0.964),the sensitivity was 0.954,and the specificity was0.969,which were higher than the three detection alone and CEA+HE4 detection.Conclusion The serum levels of CEA,AFP,and HE4 in NSCLC patients were all higher,and the three were related to the clinical stage,lymph node metastasis,degree of differentiation,and tumor diameter of NSCLC patients.

关 键 词：癌胚抗原 甲胎蛋白 人附睾上皮分泌蛋白4 非小细胞肺癌 临床特征 预后 

分 类 号：R734.2[医药卫生—肿瘤]