肿瘤标志物检测对晚期非小细胞肺癌长春瑞滨加顺铂方案化疗疗效的评价

Significance of tumor markers detection for NP chemotherapy efficacy in advanced non-small cell lung cancer

目的探讨血清癌胚抗原（CEA）、糖原抗原125（CA125）和细胞角质蛋白（CYFBA21-Ⅰ）对晚期非小细胞肺癌（NSCLC）患者化疗疗效的预测价值。方法采用回顾性调查研究的方法收集2007年1月至2013年12月山西省肿瘤医院新发的98例肺癌（Ⅲb~Ⅳ期）患者化疗前及化疗后的血清标本,应用酶联免疫吸附法检测血清中CEA、CA125和CYFRA21-1水平,并进一步探讨上述肿瘤标志物浓度变化和疗效之间的关系。结果13种肿瘤标志物水平在检测时明显高于界值,腺癌中CEA水平高于鳞癌,而其CA125和CYFBA21-1水平低于鳞癌,差异均具有统计学意义。2化疗后,患者血清中CEA、CA125和CYFRA21-1均明显下降,差异有统计学意义（P〈0.05）。3疗效评价为完全缓解（CR）和部分缓解（PR）的患者血清中CEA、CA125和CYFRA21-1浓度均明显下降,差异有统计学意义（P〈0.05）;疗效评价为疾病稳定（SD）的患者3种肿瘤标志物水平虽略有升高,但差异无统计学意义（P〉0.05）;疗效评价为疾病进展（PD）的患者化疗后3种肿瘤标志物水平均显著升高（P〈0.05）。43种肿瘤标志物浓度变化与疗效间均存在具有统计学意义的正相关关系。结论血清CEA、CA125和CYFRA21-1水平与肺癌的病理学类型有关,同时对化疗疗效有一定的评估价值。

Objective To investigate the application value of serum levels of tumor markers such as CEA,CA125 and CYFRA21-1in patients with advanced non-small cell lung cancer（NSCLC）.Methods The serum samples of 98 cases with NSCLC who stagedⅢ b andⅣduring 2007-2013 were collected.The serum levels of three tumor markers of CEA,CA125 and CYFRA21-1were detected by ELISA before and after chemotherapy.Results 1Three tumor markers increased obviously in two pathological types of lung cancer when detected before chemotherapy.2The serum levels of three tumor markers decreased after chemotherapy of NP（P〈 0.05）.3Three serum markers decreased significantly in the patients with therapeutic efficacy of CR（complete response）and PR（partial response）,but increased in the progress group（PD）.All the difference had statistical meaning.Three tumor markers increased slightly in the patients of none effective therapy（SD）group with no statistical difference.4There existed a positive association between serum markers concentration variance and efficacy,which was statistically meaningful.Conclusion Three tumor markers were correlated with the pathological type of lung cancer,and they can also be indices for chemotherapy efficacy of the lung cancer.