术前血清CEA最佳预测值对早期肺癌患者术后的复发转移价值

Optimal predictive value of preoperative serum CEA for recurrence of patients with non-small cell lung cancer at early stage

目的 探讨血清CEA最佳预测值对早期肺癌患者术后的复发转移价值.方法 收集在我院接受手术治疗并定期复查的早期肺癌,利用ROC曲线获得最佳CEA值,利用SPSS软件分析CEA在肺癌术后复发转移预测中的价值.结果 231 例Ⅰ期患者局部复发与远处转移47 例,复发转移率为20.3%（47/231）;整体人群的中位随访时间43.1月（9.5~97.2）月;其中腺癌181例,鳞癌50例.利用ROC曲线,腺癌患者中CEA取最佳预测值为2.47 ng/ml.患者术前CEA〉2.47 ng/ml与肿瘤低分化、最大径〉3 cm、脉管癌栓相关（P〈0.05）,术前CEA〉2.47 ng/ml是一个独立的危险复发转移因素（P=0.022）;鳞癌患者中CEA的最佳预测值为1.91 ng/ml,患者术前CEA〉1.91 ng/ml与年龄显著相关（P〈0.05）,术前CEA〉1.91 ng/ml是一个独立的危险复发转移因素（P=0.04）.结论 即使患者术前CEA值低于正常值（5 ng/ml）,术前CEA值在预测患者复发转移风险时也应考虑在内.

Objective To investigate the optimal predictive value of preoperative serum CEA for recurrence of patients with non-small cell lung cancer （NSCLC） at early stage. Methods 231 patients with NSCLC at early stage were selected in this study, and the optimal predictive value of CEA was calculated by ROC curve, and the re- currence value of CEA was evaluated by Spass software. Results There were 47 cases of recurrence in 231 cases, and the recurrence rate was 20.3%. The median follow-up time was 43.1 months. There were 181 cases of adenocar- cinoma and 50 cases of squamous carcinoma. The optimal predictive value of CEA in the adenocarcinoma group was 2. 47 ng/ml, and the level of CEA was correlated with tumor differentiation and size, and Vascular thrombosis. The CEA level higher than 2. 47 ng/ml was a high independent risk factor （P = 0. 022） in the adenocareinoma group. The optimal predictive value of CEA in the squamous carcinoma group was 1.91 ng,/ml, and the level of CEA was correla- ted with patients＇ age. Conclusion Even if the preoperative CEA level is within normal limits, the preoperative CEA should be considered to predict the risk recurrence.