晚期非小细胞肺癌患者培美曲塞化疗后血清肿瘤标志物变化与疗效的相关性

Correlation Between Tumor Markers Variance and Chemotherapeutic Effect of Pemetrexed on Patients with Advanced Non-small Cell Lung Cancer

目的观察晚期非小细胞肺癌(NSCLC)患者在培美曲塞单药或联合铂类化疗后血清肿瘤标志物的变化。方法回顾性分析接受培美曲塞单药或联合铂类方案化疗的NSCLC患者102例,观察化疗前和化疗第2个周期后肿瘤标志物癌胚抗原(CEA)、糖类抗原125(CA125)、细胞角质素片段抗原21-1(CYFRA21-1)、神经元特异性烯醇化酶(NSE)、鳞癌相关抗原(SCC)的变化,并根据化疗前后CT等影像学结果的改变来进行对比。结果化疗第2个周期后CEA、CA125、CYFRA21-1、NSE、SCC的均值与化疗前都有不同程度下降,其中CEA下降19.3%(P<0.05),CA125下降24.8%(P<0.05),CYFRA21-1下降18.5%(P<0.05)。患者肿瘤标志物疗效(TMR)与临床疗效(IBR)的相关性分析结果表明,CEA和CA125的TMR与IBR呈正相关;CYF21-1的TMR与IBR也呈正相关。三者联检的TMR与IBR呈正相关。结论晚期NSCLC患者化疗后血清肿瘤标志物CEA、CA125、CYFRA21-1水平的改变是反映化疗疗效的可靠指标,通过监测患者血清肿瘤标志物水平的改变可以协助判断化疗后疗效。该方法具有简便、经济的特点,在临床中具有一定的应用价值。

Objective To investigate the changes of serum levels of tumor markers during chemotherapy of single pemetrexed or combination with platinum in patients with advanced non-small cell lung cancer（NSCLC）. Methods 102 advanced NSCLC patients who experienced more than 2 cycles of chemotherapy by pemetrexed single agent or combination with platinum were retrospective analyzed.The changes of CEA,CA125,CYFRA21-1,NSE,SCC and changes of chest CT scan were recorded before and after chemotherapy. Results After chemotherapy,tumor markers like CEA,CA125,CYFRA21-1,NSE and SCC were decreased,in which CEA,CA125 and CYFRA21-1 diminished 19.3%（P0.05）,24.8%（P0.05）,and 18.5%（P0.05）,respectively.It was suggested that the correlation between tumor marker response（TMR）and imaging-based response（IBR） of CEA and CA125 was positive;the correlation between TMR and IBR of CYFRA21-1 was also positive;that between TMR and IBR of CEA,CA125 and CA19-9 joint inspection was positive as well. Conclusion Serum CEA,CA125 and CYFRA21-1 represent reliable markers for chemotherapy efficacy on patients with advanced NSCLC.Monitoring changes of serum levels of tumor markers would benefit for assessment of chemotherapy efficacy,which is simple,economic and useful in clinical settings.