CYFRA21-1对Ⅲ期非小细胞肺癌患者的临床预后意义

Prognostic significance of CYFRA 21-1 in stage III non small cell lung cancer

目的 :研究CYFRA2 1 1作为血清肿瘤标记物对Ⅲ期非小细胞肺癌患者预后判断的临床应用价值。方法 :分别于放疗前和放疗结束时采集 46例初治的Ⅲ期非小细胞肺癌患者血清样本共 92份 ,用放射免疫法检测其CYFRA2 1 1含量。临床随访 6～ 2 4月。结果 :46例初治的Ⅲ期非小细胞肺癌患者血清CYFRA2 1 1总阳性率 5 8 70 %,鳞癌 71 43 %、腺癌 3 8 89%。放疗结束时血清CYFRA2 1 1含量较放疗前显著下降 (Wilcoxon检验 ,P <0 0 0 0 1)。存活分析表明 :Ⅲ期非小细胞肺癌患者治疗前血清CYFRA2 1 1初始水平与预后无相关性 (Mantel′slog rank检验 ,P >0 0 5 ) ;放疗结束时血清CYFRA2 1 1正常组 (≤ 3 3ng/ml) 2年生存率明显高于CYFRA2 1 1升高组 ( >3 3ng/ml) (P <0 0 5 ) ;放疗结束时血清CYFRA2 1 1含量较放疗前下降≥ 5 0 %的病人 ,其 2年生存率显著高于放疗结束时血清CYFRA2 1 1含量较放疗前下降 <5 0 %的病人(P <0 0 1)。结论 :Ⅲ期非小细胞肺癌患者放疗结束时的血清CYFRA2 1 1水平是一个有意义的阴性预后指标 ,尤其是放疗后血清CYFRA2 1 1含量下降程度的大小对临床判断预后有非常重要的价值。

Objective: To evaluate the clinical application of the CYFRA 21 1 as a serum tumor marker in the prognosis of the patients with non small cell lung cancer (NSCLC) in stage Ⅲ Methods: Ninety two samples of 46 cases with stage ⅢNSCLC were collected before and at the end of radiotherapy respectively and the serum content of CYFRA 21 1 was measured in the samples with radioimmunoassay The patients were followed up for 6 24 months Results: The positive rate of CYFRA 21 1 was 58 70%for all the 46 cases of stage ⅢNSCLC, 71 43%in the cases of squamous cell carcinoma, and 38 89%in the those of adenocarcinoma The serum content of CYFRA 21 1 was decreased significantly at the end of radiotherapy (Wilcoxon test, P<0 0001) It was found that there was no significant correlation between the survival rate of the patients and the initial serum content of CYFRA 21 1 (P<0 05) As for patients with a normal level of CYFRA 21 1 (<3 3 ng/ml), their 2 year survival rate was significantly higher than that of patients with an elevated level of CYFRA 21 1 (>3 3ng/ml) at the end of the radiotherapy (P<0 05) The 2 year survival rate of the patients whose serum content of CYFRA 21 1 was decreased ≥50%after radiotherapy was significantly higher than those whose serum content of CYFRA 21 1 was decreased < 50%at the end of radiotherapy (P<0 01) Conclusion: The serum content of CYFRA 21 1 in patients with stage ⅢNSCLC especially the scale of CYFRA 21 1 decrease after radiotherapy is an important indicator for prognosis