肿瘤标志物NSE和Cyfra21-1在肺癌化疗效果评估中的价值

Clinical applicability of serum tumor markers NSE and CYFRA21-1 for assessment of efficacy of chemotherapy in patients with lung cancer

目的评价血清肿瘤标志物NSE和Cyfra21-1在肺癌化疗疗效评估中的价值,探讨其作为肺癌化疗效果评价参考指标的临床意义。方法选取2011年8月～2013年6月北京胸科医院收治确诊的肺癌患者124例,其中非小细胞肺癌（NSCLC）患者70例,小细胞肺癌（SCLC）患者54例。应用酶联免疫法检测所有肺癌患者化疗前、化疗后1个周期和化疗后2个周期血清中NSE和Cyfra21-1的水平含量。结果 SCLC患者化疗1个周期后与化疗前比较,NSE的水平显著下降[30.9 ng/mL比50.6 ng/mL],差异有高度统计学意义（P〈0.01）;NSCLC患者化疗1个周期后与化疗前比较,血清中Cyfra21-1的水平显著下降[2.67 ng/mL比8.75 ng/mL],差异有高度统计学意义（P〈0.01）。疾病进展患者化疗1个周期后与化疗前比较,血清中NSE和Cyfra21-1的水平显著升高,差异有高度统计学意义（P〈0.01）;化疗1个周期后与化疗前比较,疾病稳定和部分缓解患者血清中NSE和CYFRA21-1的水平显著下降,差异有高度统计学意义（P〈0.01）;化疗2个周期后与化疗1个周期后比较,肺癌患者血清中NSE和CYFRA21-1的水平无明显变化,差异无统计学意义（P〉0.05）。结论肿瘤标志物NSE和CYFRA21-1可作为早期的、费用低廉的肺癌化疗疗效评价参考指标,值得在临床上推广使用。

Objective To investigate the clinical significance of NSE and CYFRA21-1 as the reference indicator for assessment of efficacy of chemotherapy in patients with lung cancer. Methods From August 2011 to June 2013, in Beijing Chest Hospital Affiliated to Capital Medical University, 124 patients with lung cancer were selected, 70 cases were NSCLC and 54 cases were NSCLC. The serum levels of NSE and CYFRA21-1 were detected by ELISA before chemotherapy, after the first course treatment and after the second course treatment. Results The level of NSE in patients with SCLC after the first course treatment was significantly lower than that before chemotherapy [30.9 ng/mL vs50.6 ng/mL], the difference was statistically significant（P 0.01）; the level of CYFRA21-1 in patients with NSCLC after the first course treatment was significantly lower than that before chemotherapy [2.67 ng/mL vs 8.75 ng/mL], the difference was statistically significant（P〈0.01）. The level of NSE and CYFRA21-1 in PD patients after the first course treatment were significantly higher than that chemotherapy, the difference was statistically significant（P〈0.01）;the levels of NSE and CYFRA21-1 in SD or PR patients after the first course treatment were significantly lower than those before chemotherapy, the differences were statistically significant（P〈0.01）. There was no significant difference of the levels of NSE and CYFRA21-1 in patients after the second course treatment compared with patients after the first course treatment（P〉0.05）. Conclusion The tumor markers NSE and CYFRA21-1 are valuable to response monitoring for patients with lung cancer in early.