肺癌合并慢性阻塞性肺疾病患者肺功能与肺癌肿瘤标志物水平的关系  

The relationship between lung function and tumor marker levels in patients with lung cancer complicated with chronic obstructive pulmonary disease

作　　者：王会芳 蒋亚林[1] 瞿香坤[1] 钱会[1] WANG Huifang;JIANG Yalin;QU Xiangkun;QIAN Hui(Department of Respiratory and Critical Care Medicine,Bozhou Peoples Hospital,Bozhou 236800,China)

机构地区：[1]亳州市人民医院呼吸与危重症医学科,安徽亳州236800

出　　处：《中国肿瘤外科杂志》2024年第4期377-381,共5页Chinese Journal of Surgical Oncology

基　　金：2023年安徽省卫生健康委科研项目(AHWJ2023A20189);2023年亳州市卫生健康科研项目(bzwj2023a002)。

摘　　要：目的研究细胞角蛋白⁃19片段(CYFRA21⁃1)、癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原153(CA153)、糖类抗原199(CA199)5项肿瘤标志物及血管内皮生长因子(VEGF)水平与肺癌合并慢性阻塞性肺疾病患者肺功能及预后的关系。方法选取2021年1月至2022年6月在亳州市人民医院就诊的90例肺癌合并慢性阻塞性肺疾病患者作为观察组,选择同期体检的50例健康人群作为对照组。对比两组患者的肺功能指标及5项肿瘤标志物、VEGF水平。采用Pearson相关性分析观察组患者肺功能指标及5项肿瘤标志物、VEGF的相关性。根据观察组患者的预后情况,将其再分为预后良好组与预后不良组,对比两组的临床资料及5项肿瘤标志物、VEGF水平。采用Logistic回归分析多因素对肺癌合并慢性阻塞性肺疾病患者预后的影响。采用ROC曲线分析5项肿瘤标志物、VEGF预测肺癌合并慢性阻塞性肺疾病患者预后的价值。结果观察组的用力肺活量(FVC)、1秒用力呼气量(FEV1)及FEV1占预计值百分比(FEV1%pred)水平均低于对照组,血清细胞角蛋白⁃19片段(CYFRA21⁃1)、癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原153(CA153)、糖类抗原199(CA199)、VEGF均高于对照组(P<0.05)。Pearson相关性结果显示,肺癌合并慢性阻塞性肺疾病患者的FVC、FEV1、FEV1%pred与血清CYFRA21⁃1、CEA、CA125、CA153、CA199、VEGF呈负相关(P<0.05)。预后良好组与预后不良组患者的TNM分期、分化程度、淋巴结转移、FVC、FEV1、FEV1%pred、CYFRA21⁃1、CEA、CA125、CA153、CA199、VEGF等资料相比,差异具有统计学意义(P<0.05)。Logistic多因素回归分析结果显示,TNM分期进展、分化程度增高、淋巴结转移、FVC下降、FEV1下降、FEV1%pred下降、CYFRA21⁃1升高、CEA升高、CA125升高、CA153升高、CA199升高、VEGF升高为预后不良的危险因素。ROC曲线结果显示,CYFRA21⁃1的AUC为0.678,CEA的AUC为0.765,CA125的AUC为0.852,CObjective Objective To investigate the relationship between five tumor markers(CYFRA21⁃1,CEA,CA125,CA153,CA199),vascular endothelial growth factor(VEGF)levels and lung function and prognosis in patients with chronic obstructive pulmonary disease(COPD)complicated with lung cancer.Methods A total of 90 COPD patients with lung cancer who were treated in Bozhou People’s Hospital from January 2021 to June 2022 were selected as the observation group,and 50 healthy people who underwent physical examination in Bozhou Peoples Hospital during the same period were selected as the control group.The lung function indexes,five tumor markers and VEGF levels were compared between the two groups.Pearson correlation analysis was used to analyze the correlation between pulmonary function indexes,five tumor markers and VEGF in the observation group.According to the prognosis of the observation group,the patients were divided into a good prognosis group and a poor prognosis group,and the clinical data,five tumor markers and VEGF levels of the two groups were compared.Logistic regression analysis was used to analyze the effect of multiple factors on the prognosis of COPD patients with lung cancer.ROC curve was used to analyze the value of five tumor markers and VEGF in predicting the prognosis of COPD patients with lung cancer.Results The levels of forced vital capacity(FVC),forced expiratory volume in the first second(FEV1)and FEV1 percentage of predicted value(FEV1%pred)in the observation group were significantly lower than those in the control group.The levels of serum CYFRA21⁃1,CEA,CA125,CA153,CA199 and VEGF were significantly higher than those in the control group(P<0.05).Pearson correlation results showed that FVC,FEV1,FEV1%pred of COPD patients with lung cancer were negatively correlated with serum CYFRA21⁃1,CEA,CA125,CA153,CA199 and VEGF(P<0.05).There were significant differences in TNM stage,degree of differentiation,lymph node metastasis,FVC,FEV1,FEV1%pred,CYFRA21⁃1,CEA,CA125,CA153,CA199,VEGF and other data between

关 键 词：肿瘤标志物 血管内皮生长因子 慢性阻塞性肺疾病 肺癌 肺功能 

分 类 号：R734.2[医药卫生—肿瘤] R563.9[医药卫生—临床医学]