新辅助化疗对NSCLC患者肿瘤标记物和淋巴细胞亚群的影响

Effect of neoadjuvant chemotherapy on the tumor marker and hymphocycte in patients with NSCLC

目的探讨新辅助化疗对费小细胞肺癌(NSCLC)肿瘤标记物、淋巴细胞亚群的影响。方法比较NSCLC肿瘤患者CEA、CA-125、CYFRA21-1的水平及CD3+、CD4+、CD8+比例变化。结果腺癌、鳞癌患者CEA、CA-125和CYFRA21-1水平均显著增高;鳞癌患者CEA升高水平低于腺癌,而鳞癌CA-125和CYFRA21-1升高水平高于腺癌。腺癌、鳞癌患者CD3+、CD4+、CD4+/CD8+均显著降低,而CD8+升高。2个周期化疗后,缓解和部分缓解共18例,稳定和进展共22例。新辅助化疗后,鳞癌患者CA-125和CYFRA21-1显著降低,腺癌患者血清CEA和CYFRA21-1水平显著降低,鳞癌、腺癌患者CD3+、CD4+、CD4+/CD8+升高,CD8+降低。结论 NSCLC的血清肿瘤标记物表达有差异,可作为评价新辅助化疗疗效的指标。

Objective To observe the effect of neoadjuvant chemotherapy in NSCLC tumor markers and lymphocyte subsets.Method The levels of CEA,CA- 125,CYFRA21- 1 in NSCLC tumor and the ratio of CD3＋,CD4＋,CD8＋were compared.Results The levels of CEA,CA-125 and CYFRA21- 1 in patients with adenocarcinoma and squamous cell carcinoma significantly increased.The elevated levels of CEA in patients with squamous cell carcinoma were less than with adenocarcinoma,while the levels CA- 125 and CYFRA21- 1 in patients with squamous cell carcinoma were higher than patients with adenocarcinoma.The levels of CD3＋,CD4~＋,CD4~＋/CD8~＋ of patients with adenocarcinoma and squamous cell carcinoma were siginificantlyy decreased,while CD8＋ increased.After two courses of chemotherapy,remission and partial remission was noticed in 18 cases,22 cases of stability and progress.After neoadjuvant chemotherapy,the levels of CA-125and CYFRA21-1 in patients with squamous cell carcinoma evidently decreased.The levels of CEA and CYFRA21-1 in patients with adenocarcinoma were remarkably reduced.The levels and ratio of CD3~＋,CD4~＋,CD4~＋/CD8~＋ in patients with squamous cell carcinoma and adenocarcinoma were increased,while the levels of CD8~＋ declined.Conclusion The expression of serum tumor markers in NSCLC can be used as indicators for the efficacy of evaluating the efficacy of neoadjuvant chemotherapy.