Iressa治疗晚期肺腺癌患者的血清肿瘤标志物水平变化及意义

Investigation of tumor marker changs in the treatment of iressa for 31 advanced lung adenocarcinoma patients

目的:探讨晚期肺腺癌患者接受Iressa治疗前后肿瘤标志物血清水平变化及意义。方法:应用酶联免疫吸附法(ELISA)检测31例临床B～期肺腺癌患者经过1～3个月的Iressa治疗前后肿瘤标志物癌胚抗原(CEA)、细胞角质蛋白-19片断抗原(Cyfra21-1)、组织多肽特异性抗原(TPS)以及神经元特异性烯醇化酶(NSE)血清水平的变化。结果:Iressa治疗后明显缓解(CR+PR)病例TPS血清水平较治疗前显著降低(P<0.05),进展病例(PD)则显著升高(P>0.05),稳定病例(SD)治疗前后无显著变化(P>0.05);CEA、Cyfra21-1及NSE血清水平治疗前后均无显著变化(P>0.05);各组治疗前肿瘤标志物血清水平比较中,仅SD组与PD组之间TPS存在显著性差异(P>0.05),但疗效和治疗前TPS血清水平之间无显著相关性(P>0.05);各组之间其余肿瘤标志物血清水平均无显著性差异(P>0.05);TPS血清水平改变量在不同疗效组之间存在显著性差异(P<0.05)。结论:监测肿瘤标志物TPS血清水平的变化有助于晚期肺腺癌患者Iressa疗效的判断,具有一定的临床价值,但化疗前TPS血清水平高低不能作为预测Iressa疗效的指标。

Objective： To investigate the role of tumor marker changes in evaluating the therapeutic effect of for among advanced lung adenocarcinoma patients. Methods： Thirty-one patients with stage ⅢB-Ⅳ lung adenocarcinoma ,pathologically proved were given 1-3 month treatment of Iressa. The serum levels of TPS,CEA,Cyfra21-1 and NSE before and after therapy were measured by ELISA method. Results： Serum TPS level after therapy was statistically different from the value before therapy （P〈0. 05）, CEA,Cyfra21-1 and NSE showed no significant difference from the value before therapy（P〉0.05）. Serum TPS level before therapy was different only between the group of SD and PD（P〈0. 05）. The quantity of the change of TPS was different according to the effect （P〈0. 05）, while that of CEA, Cyfra21-1 and NSE had no differenee（P〉0.05）. Conclusion, Monitoring serum TPS level could help to valuate the therapic effect of Iressa for advanced lung adenocarcinoma patients,but the serum level of TPS before therapy could not prognosticate the effect of Iressa, though it was simple and cost-effective.