晚期非小细胞肺癌患者放疗前后肿瘤标志物变化与近期疗效的临床分析

Change of serum tumor markers and short-term efficacy after radiotherapy in advanced non-small cell lung cancer patients

目的回顾性研究晚期非小细胞肺癌患者放疗前后血清CEA、CYFAR21—1、SCC、CA125的水平变化，探讨血清肿瘤标志物的改变及与放疗近期疗效的关系。方法常规检查205例经确诊的晚期非小细胞肺癌患者放疗前、后血清CEA、CYFAR21—1、SCC、CA125等肿瘤标志物的水平（应用电化学发光法），同时评估放疗的近期疗效，分析肿瘤标志物的变化及与近期疗效的关系。结果205例患者放疗后近期有效113例，总有效率为55．1％。此113例患者放疗后血清CEA、CYFAR21—1、SCC、CA125水平均较放疗前发生了明显下降（t=3．224，2．896，3．137，3．219，P〈0．05），其中Ⅲ期及Ⅳ期患者血清肿瘤标志物CEA、CYFAR21—1、SCC、CA125放疗后与放疗前比较，差异均有统计学意义（Ⅲ期：t=2．484，2．445，2．148，2．109，P〈0．05；Ⅳ期：t=2．072，2．857，2．277，2．436，P〈0．05）；而放疗后近期非有效的92例患者中，放疗后血清肿瘤标志物较放疗前明显上升（t=2．224，2．005，2．261，2．545，P〈0．05）。放疗后肿瘤标志物降低组的近期疗效明显好于肿瘤标志物升高组，差异有统计学意义（χ2=80．001，P〈0．01）结论血清肿瘤标志物CEA、CYFAR21—1、SCC、CA125水平或可用于晚期非小细胞肺癌患者放疗后的近期疗效评估。

Objective To investigate the change of the serum levels of CEA, CYFAR21-1, SCC, CA125 in advanced non-small cell lung cancer.patients before and after radiotherapy retrospectively and to explore the relationship between the change of serum tumor markers and the short-term efficacy of radiotherapy. Methods The serum levels of CEA, CYFAR21-1, SCC, CA125 in 205 cases with advanced non-small cell lung cancer＇were detected （ by electro-chemiluminescence immunoassay method） before and after radiotherapy, and the short-term efficacy of radiotherapy was assessed （RECIST 1.1 edition） at the same time. The changes in tumor markers and the short-term efficacy were analyzed. Results Totally 113 patients achieved response of short-term efficacy after radiotherapy, and the effective rate of the short-term efficacy was 55.1%. Among these 113 patients, the serum levels of tumor markers decreased significantly after radiotherapy（ t = 3. 224, 2. 896, 3. 137, 3. 219, P 〈 0. 05 ）. The serum levels of tumor markers in patients with stage and decreased after radiotherapy （ t =2. 484, 2. 445,2. 148, 2. 109, P 〈0.05 ;t =2. 072, 2. 857, 2. 277, 2. 436, P 〈0. 05）. Among 92 patients who did not achieve response of short-term efficacy, the serum level of tumor markers increased significantly after radiotherapy（ t = 2. 224, 2. 005, 2. 261, 2. 545, P 〈 0.05 ）. For the patient who achieved response of radiotherapy with tumor markers decreased, the short-term efficacy was significantly better than the group of which tumor maker increased （χ2 = 80. 001, P 〈 0. 01 ）. Conclusions The serum levels of CEA, CYFAR21-1, SCC,CA125 can be used for assessment of short-term efficacy after radiotherapy in advanced non-small cell lung cancer patients.