晚期肺癌患者光子刀治疗前后肺泡灌洗液、血清铁蛋白、CA-199、CEA的临床意义

The clinical value of determination of SF,CA-199 and CEA in bronchoalveolar lavage fluid and serum on terminal lung cancer patients treated by photon knife radiotherapy

目的探讨支气管肺泡灌洗液(BALF)、血清铁蛋白(SF)、糖链抗原199(CA-199)和癌胚抗原(CEA)测定在晚期肺癌光子刀放疗中的临床意义。方法采用免疫放射分析法(IRMA)测定48例肺癌患者放疗前及放疗后、放疗后3个月、放疗后半年及58例肺良性疾病患者BALF和血清中SF、CA-199、CEA的水平。结果肺癌组BALF和血清中SF、CA-199、CEA明显高于肺良性疾病组,差异有统计学意义(P<0.01);肺癌组内BALF的SF、CA-199、CEA水平高于血清(P<0.01),而肺良性疾病组各项检测指标间差异无统计学意义(P>0.05);肺癌组BALF及血清中SF、CA-199、CEA在放疗后各期均低于放疗前(P<0.01),各项指标以放疗后3个月内下降较快,其后下降缓慢。结论铁蛋白、CA-199、CEA与肺癌的病情变化呈负相关,其在肺泡灌洗液中较血清更敏感,对晚期肺癌患者光子刀放疗的病情动态变化、估计预后有一定的参考价值。

Objective To explore the clinical value of determination of SF, CA-199 and CEA in bronchoalveolar lavage fluid and serum on terminal lung cancer patients who were treated by photon knife. Methods IRMA was utilized to determine in serum SF, CA-199 and CEA, before, after and 6 months after the radiotherapy on 48 terminal lung cancer patients who were treated by photon knife （ the experimental group）. 58 patients of benign lung disease （ the contrast group） were included for comparison. Results The concentration level of SF, CA-199, CEA in BALF and serum in the experimental group was significant higher than that in the contrast group （P 〈 O. 01 ）. In the experimental group, each indicatrix of BALF was higher than that in serum （P 〈 0. 01 ） , but in the contrast group, no difference was found. The concentration level of SF, CA-199 and CEA on each stage of the experimental group was significant lower than that before the radiotherapy （P 〈 0. 01 ）. The indicatrix＇s descent was more manifested 3 months after the radiotherapy, and in the following period the descent was slow. Conclusion The SF, CA-199 and CEA are negatively correlated with the terminal lung cancer patient＇ s conditions after the radiotherapy, especially in BALF. It is significant to determine SF, CA-199 and CEA on terminal lung cancer patients who were treated by photon knife. It could be applied to reflect the patient＇s conditions to assess the prognosis.