血浆循环游离DNA(cf DNA)联合癌胚抗原(CEA)在评估晚期非小细胞肺癌治疗疗效的临床价值  

Clinical Value of Circulating Cell-free DNA(cf DNA) Combined with Carcinoembryonic Antigen(CEA) on Rvaluating the Therapeutic Rfficacy of Advanced Non-small Cell Lung Cancer

作　　者：冯访梅 郭人花[1] 刘中秋 陈琳[4] 武宜婷[2] FENG Fang-mei;GUO Ren-hua;LIU Zhong-qiu;CHEN Lin;WU Yi-ting(the First Affiliated Hospital with Nanjing Medical University,Nanjing,Jiangsu,210029,China;Department of Oncology,Jiangbei Hospital District,Zhongda Hospital Affiliated to Southeast University,Nanjing,Jiangsu,210000,China;Department of Pharmacy,Jiangbei Hospital District,Zhongda Hospital Affiliated to Southeast University,Nanjing,Jiangsu,210000,China;Jiangsu Cancer Hospital,Nanjing,Jiangsu,210009,China)

机构地区：[1]南京医科大学第一附属医院,江苏南京210029 [2]东南大学附属中大医院江北院区肿瘤科,江苏南京210000 [3]东南大学附属中大医院江北院区药剂科,江苏南京210000 [4]江苏省肿瘤医院,江苏南京210009

出　　处：《现代生物医学进展》2023年第1期93-97,92,共6页Progress in Modern Biomedicine

基　　金：国家自然科学基金青年项目(8210012370)。

摘　　要：目的:研究血浆循环游离DNA(cf DNA)联合癌胚抗原(CEA)在评估晚期非小细胞肺癌(NSCLC)治疗疗效中的临床价值。方法:选取我院2019年1月~2022年1月收治的96例晚期NSCLC患者作为研究对象,所有患者均接受含铂双药化疗方案或放疗,评估治疗6个月后的临床疗效,根据疗效分为有效组与无效组,检测所有患者cf DNA及CEA水平并进行比较,单因素、多因素分析患者疗效的影响因素,并通过受试者工作特征曲线图(ROC)分析cf DNA及CEA对晚期NSCLC患者治疗疗效的评估价值。结果:本研究中96例患者均顺利完成化疗治疗,疗程结束后,有54例(56.25%)治疗有效,42例(43.75%)治疗无效;无效组肿瘤TNM分期Ⅳ期、体力状况(PS)评分2~4分占比大于有效组(P<0.05);无效组患者cf DNA及CEA水平明显高于有效组(P<0.05);多因素Logistic回归分析显示,肿瘤分期Ⅳ期、PS评分2~4分、cf DNA及CEA高水平均为影响晚期NSCLC患者疗效的相关因素(P<0.05);ROC曲线分析显示,cf DNA、CEA对晚期NSCLC患者治疗后无效均有预测效能(P<0.05),其中两指标联合预测的曲线下面积(AUC)最大,为0.794,特异度、敏感度分别为85.19%、78.57%。结论:治疗无效晚期非小细胞肺癌患者cf DNA及CEA水平更高,肿瘤分期Ⅳ期、PS评分2~4分、cf DNA及CEA高水平均为晚期NSCLC患者疗效的影响因素,联合cf DNA及CEA检测有利于对晚期NSCLC患者治疗疗效进行评估。Objective:To study the clinical value of combination of circulating cell-free DNA(cf DNA) and carcinoembryonic antigen(CEA) on evaluating the therapeutic efficacy of advanced non-small cell lung cancer(NSCLC).Methods:96 patients with advanced NSCLC who were treated in the hospital between January 2019 and January 2022 were selected as the research subjects.All patients received platinum-containing dual-drug chemotherapy or radiotherapy,and the clinical efficacy after 6 months of treatment was evaluated.According to the efficacy,the patients were classified onto effective group and ineffective group.The levels of cf DNA and CEA in all patients were detected and compared,and the influencing factors of efficacy were analyzed by univariate analysis and multivariate analysis.Receiver operating characteristic curve(ROC) was used to analyze the evaluated value of cf DNA and CEA on the therapeutic efficacy of patients with advanced NSCLC.Results:96 patients successfully completed chemotherapy treatment.After the end of the course of treatment,54 patients(56.25%) were treated effectively,and 42 patients(43.75%) were ineffective.The proportions of tumor TNM stage IV and physical status(PS) score of 2-4 points in ineffective group were higher than those in effective group(P<0.05).The levels of cf DNA and CEA were also significantly higher than those in effective group(P<0.05).Multivariate Logistic regression analysis showed that tumor stage IV,PS score of 2-4 points,and high levels of cf DNA and CEA were all related factors affecting the efficacy of patients with advanced NSCLC(P<0.05).ROC curve analysis showed that cf DNA and CEA had predictive efficiency on ineffectiveness in patients with advanced NSCLC after treatment(P<0.05),and the area under the curve(AUC) of the combination of the two indicators was the largest at 0.794,with the specificity of 85.19% and sensitivity of 78.57%.Conclusion:The levels of cf DNA and CEA in patients with advanced non-small cell lung cancer and ineffective treatment are higher,and tumor st

关 键 词：血浆循环游离DNA 癌胚抗原 晚期非小细胞肺癌 疗效评估 

分 类 号：R734.2[医药卫生—肿瘤]