肿瘤标记物细胞角蛋白19片段抗原21⁃1、ALI、PLR在非小细胞肺腺癌中的表达及预后评估  

Expression and prognostic value of tumor markers cytokeratin 19 fragment antigen 21⁃1,ALI and PLR in non⁃small cell lung adenocarcinoma

作　　者：吴琼 王远飞 项海均 刘劲 王尚虎 WU Qiong;WANG Yuanfei;XIANG Haijun;LIU Jin;WANG Shanghu(Department of Oncology,Huangshan Shoukang Hospital,Huangshan,Anhui,China,245000;Depart-ment of Oncology,Anhui Chest Hospital,Hefei,Anhui,China,230022)

机构地区：[1]黄山首康医院肿瘤科,安徽黄山245000 [2]安徽省胸科医院肿瘤科,安徽合肥230022

出　　处：《分子诊断与治疗杂志》2024年第8期1573-1576,1581,共5页Journal of Molecular Diagnostics and Therapy

基　　金：安徽省卫生健康委科研项目计划任务书(AHWJ2021b149)。

摘　　要：目的探讨分析肿瘤标记物细胞角蛋白19片段抗原21⁃1(CYFRA21⁃1)、晚期肺癌炎症指数(ALI)、血小板/淋巴细胞比值(PLR)在非小细胞肺腺癌中的表达及预后评估价值。方法选取2020年1月至2023年10月于安徽黄山首康医院肿瘤科初次经病理学确诊为非小细胞肺腺癌的患者共计150例,根据其病理分期分为Ⅰ期25例、Ⅱ期10例、Ⅲ期36例及Ⅳ期79例,比较不同分期患者CYFRA21⁃1水平及ALI、PLR值。根据患者影像学随访预后情况分为稳定组54例及进展组96例,比较两组患者临床特征及CYFRA21⁃1水平及ALI、PLR值,采用多因素Logistic回归分析影响预后的相关因素,并以ROC曲线分析CYFRA21⁃1、ALI、PLR对预后的评估价值。结果随着病理分期的增大,CYFRA21⁃1水平及PLR值依次升高,ALI值依次降低,差异有统计学意义(F=83.871,224.621,189.263,P<0.05);进展组吸烟史、饮酒史、Ⅲ~Ⅳ期患者占比、CYFRA21⁃1、PLR均高于稳定组,ALI则低于稳定组,差异有统计学意义(χ^(2)=9.103,5.809,5.221,11.413;t=11.090,10.272,8.966,P<0.05);吸烟史、Ⅲ~Ⅳ期及CYFRA21⁃1、ALI、PLR均是肺癌患者疾病进展的独立影响因素(P<0.05);CYFRA21⁃1、ALI、PLR联合检测评估肺癌进展的AUC=0.982,均高于单一检测(P<0.05)。结论CYFRA21⁃1水平及PLR、ALI值与非小细胞肺腺癌的病情密切相关,三者均是非小细胞肺腺癌患者预后不良的独立影响因素,联合检测对于评估患者预后不良的预测价值较高。Objective To investigate the expression and prognostic value of tumor marker cytokeratin 19 fragment antigen 21⁃1(CYFRA21⁃1),advanced lung cancer inflammatory index(ALI),platelet/lymphocyte ratio(PLR)in non⁃small cell lung adenocarcinoma.Method A total of 150 patients with non⁃small cell lung adenocarcinoma who were pathologically diagnosed for the first time in the Oncology Department of Huangshan Shoukang Hospital,Anhui Province from January 2020 to October 2023 were retrospectively selected.They were divided into stageⅠ(25 cases),stageⅡ(10 cases),stageⅢ(36 cases)and stageⅣ(79 cases)based on their pathological stages.The levels of CYFRA21⁃1,ALI and PLR in patients with different stages were compared.Based on imaging follow⁃up prognosis,the patients were further divided into a stable group of 54 cases and a progressive group of 96 cases.The clinical characteristics,CYFRA21⁃1 levels,ALI and PLR values of the two groups were compared,and the related factors affecting prognosis were analyzed using multivariate logistic regression.The prognostic value of CYFRA21⁃1,ALI and PLR was assessed using ROC curve analysis.Results As the pathological stage increased,the levels of CYFRA21⁃1 and PLR value also increased successively,while the ALI value decreased successively,the difference was statistically significant(F=83.871,224.621,189.263,P<0.05).The progressive group had a higher proportion of patients with a smoking and drinking history,stageⅢtoⅣ,CYFRA21⁃1,and PLR levels compared to the stable group.Conversely,the ALI value was lower in the progressive group.These differences were statistically significant(χ^(2)=9.103,5.809,5.221,11.413;t=11.090,10.272,8.966,P<0.05).Smoking history,stageⅢtoⅣ,CYFRA21⁃1,ALI and PLR were identified as independent influencing factors for disease progression in lung cancer patients(P<0.05).The combined assay of CYFRA21⁃1,ALI,and PLR had an AUC of 0.982,which was significantly higher than that of a single assay(P<0.05).Conclusion CYFRA21⁃1 levels,PLR,

关 键 词：CYFRA21⁃1 ALI PLR 预后 非小细胞肺腺癌 

分 类 号：R734.2[医药卫生—肿瘤]