化疗药物对肺癌患者血浆ET、CYFRA_(21-1)、CEA影响的观察

Dynamic Observation of the Effect of Chemotherapeutic Agents on Plasma ET,CYPRA_(21-1),CEA in Lung Cancer Patients

目的:检测肺癌患者血浆内皮素(Endothlin,ET)、细胞角蛋白19片段(CytokerationFragmentAntigen21-1,CYFRA21-1)、癌胚抗原(Carcinoembryonicantign,CEA)水平及化疗对它们的影响,以探讨血浆ET、CYFRA21-1、CEA在肺癌发病及预后过程中的作用。方法:应用放射免疫分析法检测29例正常人及68例肺癌患者化疗前、化疗1个周期后、化疗2个周期后血浆ET、CYFRA21-1、CEA测值,并进行对比分析。结果:化疗前非小细胞肺癌患者血浆ET、CYFRA21-1测值高于正常对照组(P<0.01),化疗后ET、CYFRA21-1、CEA与化疗前比较差异有显著性(P<0.05或P<0.01);而小细胞肺癌患者ET、CYFRA21-1、CEA测值则无明显变化(P>0.05)。化疗前Ⅱ～Ⅳ期肺癌患者ET、CYFRA21-1测值高于正常对照组(P<0.01),Ⅱ、Ⅲ、Ⅳ各期间ET有显著性差异(P<0.05),而CYFRA21-1、CEA测值差异无显著性(P>0.05)。提示血浆ET的水平与非小细胞肺癌的临床分期相平行,病期越晚者血浆ET测值越高。血浆ET、CYFRA21-1、CEA的水平与疗效呈正相关(P<0.05)。血浆ET测值受心脏病、吸烟、性别因素的影响,血浆CEA测值受吸烟因素的影响。结论:ET、CYFRA21-1、CEA可能与非小细胞肺癌有关联,化疗可使ET、CYFRA21-1、CEA水平降低,而对小细胞肺癌则无明显影响。肺癌患者ET、CYFRA21-1、CEA?

Objective:To detect the levels of plasma endothelin(ET),cytokeration fragment antigen21-1(CYFRA21-1),carcinoembryonic antigen(CEA)in patients with lung cancer and the effects of chemotherapy on them,and to study the possible role of ET,CYFRA21-1,CEA in the development and prognosis of lung cancer.Methods:Radioimmunoassay was available to detect the levels of ET,CYFRA21-1,CEA in68patients with lung cancer before and after the first cycle and the second cycle of chemotherapy,for29normal persons of control group,the levels of ET were detected.Results:The levels of ET,CYFRA21-1,CEA in squamous cell carcinoma and adenocarcinoma after chemotherapy were much lower than those before chemotherapy,the dif-ferences were significant (P<0.01),and ET,CYFRA21-1before chemotherapy were higher than those in the control group(P<0.01).But the differences were not significant in the patients with small cell lung cancer(P>0.05).The levels of ET,CYFRA21-1in clinical stageⅡ～Ⅳwere higher than those in normal control group(P<0.01),while the levels of ET,CYFRA21-1,CEA in stageⅡ～Ⅳwere lower after chemotherapy than those before treatment.The difference of ET be-tween the four stages were significant (P<0.05),but the differences of CYFRA21-1,CEA between the four stages were not significant (P>0.05).The level of ET was parallel with the clinical stage of the lung cancer.There were positive correlations between the levels of ET,CYFRA21-1,CEA and their curative effects(P<0.05).Cardiovascular disease,smoking and male could raise the level of ET.Smoking could influence the level of CEA.Conclusion:ET,CYFRA21-1,CEA may be associated with squamous cell carcinoma and adenocarcinoma,but not in small cell lung cancer.Chemotherapy can remarkably decrease the level of plasma ET,CYFRA21-1,CEA in squamous cell carcinoma and adenocarcinoma,but it may not do in small cell lung cancer.The elevation of plasma ET,CYFRA21-1,CEA may be a tumor marker in progressive lung cancer.The levels of plasma ET,CYFRA21-1,CEA may be a clinical index of tumor curative effect,but the effects of cardiovascular disease,smoking and sex factor to ET,CEA must be considered.