血清CYFRA21-1、NSE、SCC联合预测肺癌根治术后复发的价值  

Value of Serum CYFRA21-1,NSE and SCC in Combination in Predicting Recurrence of Patients with Lung Cancer after Radical Surgery

作　　者：柯昌康 刘红岗 KE Changkang;LIU Honggang(Department of Thoracic Surgery,the Second Affiliated Hospital of Air Force Medical University of the Chinese People's Liberation Army,Xi'an 710000,China)

机构地区：[1]解放军空军军医大学第二附属医院胸腔外科,西安710000

出　　处：《临床误诊误治》2025年第8期34-38,共5页Clinical Misdiagnosis & Mistherapy

基　　金：国家自然科学基金(81572252)。

摘　　要：目的探讨血清细胞角蛋白19片段抗原(CYFRA21-1)、神经元特异性烯醇化酶(NSE)、鳞状上皮细胞癌抗原(SCC)联合预测肺癌根治术后复发的价值。方法选取2020年1月至2021年7月行肺癌根治术后患者100例,根据随访2年内是否复发,分为复发组21例及未复发组79例。检测2组血清CYFRA21-1、NSE、SCC水平,并比较2组临床特征,采用受试者工作特征(ROC)曲线分析血清CYFRA21-1、NSE、SCC预测肺癌根治术后复发的价值,采用多因素logistic回归分析肺癌根治术后复发的危险因素。结果ROC曲线显示,血清CYFRA21-1、NSE、SCC联合预测肺癌根治术后复发的曲线下面积均大于单一指标预测(P<0.01)。多因素logistic回归分析显示:TNM分期为Ⅲ期、分化程度为低分化、术后无辅助化疗、肿瘤最大直径>3 cm、术前存在淋巴结转移、CYFRA21-1>4.608 ng/mL、NSE>19.511 ng/mL、SCC>1.776 ng/mL均是肺癌根治术后复发的危险因素(P<0.05,P<0.01)。结论血清CYFRA21-1、NSE、SCC与肺癌根治术后患者复发密切相关,3项指标联合检测有助于提高术后患者复发预测的敏感度。Objective To investigate the value of serum cytokeratin-19 fragment(CYFRA21-1),neuron-specific enolase(NSE)and squamous cell carcinoma antigen(SCC)in predicting the recurrence of patients with lung cancer after radical surgery.Methods A total of 100 patients who underwent radical surgery for lung cancer from January 2020 to July 2021 were selected and divided into a recurrence group(n=21)and a non-recurrence group(n=79)according to recurrence within 2 years of follow-up.Serum CYFRA21-1,NSE and SCC levels were detected between the two groups,and the clinical characteristics between the two groups was compared.The value of serum CYFRA21-1,NSE and SCC in predicting the recurrence of lung cancer after radical surgery was analyzed by receiver operating characteristic(ROC)curve.Multivariate logistic regression was used to analyze the risk factors of recurrence of lung cancer after radical surgery.Results ROC curve showed that the combined detection of serum CYFRA21-1,NSE and SCC in predicting the recurrence of lung cancer after radical surgery was greater than that predicted by single index(P<0.01).Multivariate logistic regression analysis showed that,The TNM stageⅢ,low differentiation,no adjuvant chemotherapy after surgery,the maximum tumor diameter>3 cm,presence of lymph node metastasis before surgery,CYFRA21-1>4.608 ng/mL,NSE>19.511 ng/mL,and SCC>1.776 ng/mL were risk factors for recurrence of lung cancer after radical surgery(P<0.05,P<0.01).Conclusion Serum CYFRA21-1,NSE and SCC are closely related to the prognosis of patients after radical surgery for lung cancer,and the combined detection of these three indexes is helpful to improve the sensitivity of recurrence prediction in patients.

关 键 词：肺肿瘤 肺癌根治术 细胞角蛋白19片段抗原 神经元特异性烯醇化酶 鳞状上皮细胞癌抗原 预后 预测价值 影响因素分析 

分 类 号：R734.2[医药卫生—肿瘤]