CA72-4、CA15-3、AFP及NSE评估非小细胞肺癌患者术后预后的价值观察  

Value of CA72-4,CA15-3,AFP and NSE on Evaluating Postoperative Prognosis of Patients with Non-small Cell Lung Cancer

作　　者：郭爱霞 王珍 孙倩 万红波 GUO Aixia;WANG Zhen;SUN Qian(Zhumadian Central Hospital,Zhumadian,463000)

机构地区：[1]河南省驻马店市中心医院,463000

出　　处：《实用癌症杂志》2023年第3期422-426,共5页The Practical Journal of Cancer

摘　　要：目的 研究糖类抗原72-4(CA72-4)、糖类抗原15-3(CA15-3)、甲胎蛋白(AFP)及神经元特异性烯醇化酶(NSE)评估非小细胞肺癌(NSCLC)患者术后预后的价值。方法 选行手术治疗的136例NSCLC患者作为研究对象(NSCLC组),采用化学发光法检测所有患者CA72-4、CA15-3、AFP及NSE水平,并采用Spearman秩相关分析法分析上述指标与NSCLC临床分期的相关性,采用多因素Logistic回归法分析患者预后的影响因素,并通过绘制受试者工作特征曲线图(ROC)分析上述指标预测NSCLC患者不良预后的价值。结果 随访截止,136例患者中死亡39例(28.68%),生存97例(71.32%),死亡组患者中有吸烟史、Ⅲ~Ⅳ期、低分化占比高于存活组(P<0.05);死亡组患者血清CA72-4、CA15-3、AFP、NSE水平明显高于存活组(P<0.05);多因素Logistic回归分析显示,Ⅲ~Ⅳ期、低分化、CA72-4、CA15-3、AFP、NSE高水平均为影响NSCLC患者术后预后的危险因素(P<0.05);Spearman秩相关分析显示,NSCLC患者CA72-4、CA15-3、AFP、NSE水平与临床分期均有关(P<0.05);ROC曲线显示,CA72-4、CA15-3、AFP、NSE对NSCLC患者不良预后均有较高的预测效能(P<0.05),其中四指标联合预测NSCLC患者不良预后的曲线下面积(AUC)最大,为0.803,特异度、敏感度分别为74.36%、79.38%。结论 NSCLC死亡患者CA72-4、CA15-3、AFP及NSE水平高于存活患者,上述指标与肿瘤临床分期呈正相关,且高水平CA72-4、CA15-3、AFP及NSE是造成患者预后不良的危险因素,联合上述指标检测有利于对患者预后做出判断。Objective To study the value of carbohydrate antigen 72-4(CA72-4),carbohydrate antigen 15-3(CA15-3),alpha-fetoprotein(AFP) and neuron-specific enolase(NSE) on evaluating the postoperative prognosis of patients with non-small cell lung cancer(NSCLC).Methods 136 patients with NSCLC who underwent surgical treatment were selected as the research subjects(NSCLC group).The levels of CA72-4,CA15-3,AFP and NSE were detected among all patients by chemiluminescence method.Spearman rank correlation analysis method was used to analyze the correlation between the above indicators and the clinical staging of NSCLC,and multivariate Logistic regression method was applied to analyze the influencing factors of prognosis of patients.Receiver operating characteristic(ROC) curve was drawn to analyze the value of the above indicators on predicting the poor prognosis of patients with NSCLC.Results At the end of follow-up, 39 cases(28.68%) of 136 patients died and 97 cases(71.32%) survived.The proportions of patients with smoking history, stage Ⅲ to Ⅳ and poor differentiation were higher in death group than those in survival group(P<0.05).Multivariate Logistic regression analysis showed that stage Ⅲ to Ⅳ,poor differentiation and high levels of CA72-4,CA15-3,AFP and NSE were the risk factors affecting the postoperative prognosis of patients with NSCLC(P<0.05).Spearman rank correlation analysis revealed that the levels of CA72-4,CA15-3,AFP and NSE in patients with NSCLC were related to clinical staging(P<0.05).ROC curve showed that CA72-4,CA15-3,AFP,and NSE all had high predictive efficiency on poor prognosis of patients with NSCLC(P<0.05).The area under the curve(AUC) of the combined detection with the above four indicators for predicting the poor prognosis of patients with NSCLC was the largest at 0.803,and its specificity and sensitivity were 74.36% and 79.38% respectively.Conclusion The levels of CA72-4,CA15-3,AFP and NSE in dead patients with NSCLC are higher than those in surviving patients, and the above indicators are posi

关 键 词：糖类抗原72-4 糖类抗原15-3 甲胎蛋白 神经元特异性烯醇化酶 预后 

分 类 号：R734.2[医药卫生—肿瘤]