非小细胞肺癌患者术后细胞角蛋白19片段水平与预后的关系

Relationship of postoperative serum cytokeratin 19fragment and prognosis of patients with stageⅠ nonsmall cell lung cancer

目的分析Ⅰ期非小细胞肺癌(NSCLC)患者手术前后血清细胞角蛋白19片段(CYFRA21-1)水平与预后之间的关系。方法采用罗氏法测定225例经术后病理确诊为Ⅰ期NSCLC患者手术前后血清CYFRA21-1水平。225例中,吸烟者143例,非吸烟者82例;鳞癌患者40例,非鳞癌患者185例。结果吸烟者术前血清中CYFRA21-1水平高于非吸烟者(P<0.05);鳞癌患者与非鳞癌患者血清中CYFRA21-1水平差异无统计学意义。术后血清CYFRA21-1水平降低患者生存率好于CYFRA21-1水平升高患者(P<0.05);ⅠB期及血清中CYFRA21-1水平明显升高患者预后较差(P<0.05)。结论术后CYFRA21-1水平升高患者预后较差,可作为NSCLC患者术后综合治疗、判断疗效的参考指标。

Objective To analyze the correlation between the changes in serum cytokeratin 19 fragment（CYFRA21-1） after operation and the prognosis of the patients with stage I non-small cell lung cancer（NSCLC）. Methods Serum CYFRA21-1 was detected in 225 patients with stage I NSCLC before and after operation. Of 225 cases, 143 cases were the smokers and 82 cases were the non- smokers, 40 cases were with squamous carcinoma, and 185 cases were with non-squamous carcinoma. Results Before surgery, serum CYFRA21-1 level was higher in smokers than non-smokers （P^0. 05）, which was not significantly different between squamous carcinoma cases and non- squamous carcinoma. The survival rate was higher in the patients with remarkable reduction of serum CYFRA21-1 level after surgery than those with elevated serum CYFRA21-1 level. The patients with a persistently high level of serum CYFRA21-1 and in IB stage had poor prognosis. Conclusion An increased serum level of CYFRA21-1 predicts a poor prognosis, which may be taken as an indicator for the treatment and evaluation of prognosis in the patients with NSCLC.