Ⅲb期NSCLC同步放化疗前后血清肿瘤标志物的水平变化与疗效评估

The level changes of tumor markers before and after concurrent chemo-radiotherapy in patients with Ⅲb NSCLC and its curative effect evaluation

目的探讨同步放化疗对Ⅲb期NSCLC者血清肿瘤标志物的影响与疗效评估。方法选取2014年1月-2016年1月初次就诊于合肥市第二人民医院肿瘤放疗科科68例Ⅲb期NSCLC患者作为治疗组(肺癌组),予以同步放化疗方案治疗,治疗2个周期后1个月复查肿瘤标志物并评价疗效,体检健康者血清肿瘤标志物水平作为对照组(健康组)。结果肺癌组患者治疗前血清中CEA、SCC-Ag、CYFRA21-1和TK1水平高于健康组(P≤0.05),而NSE的水平两组之间比较,差异无统计学意义;肺癌组同步放化疗后患者血清中CEA、SCC-Ag、CYFRA21-1和TK1水平低于治疗前(P≤0.05);CEA在腺癌中的水平明显高于鳞癌,SCCAg、CYFRA21-1、TK1在鳞癌中的水平明显高于腺癌(P≤0.05),NSE在鳞癌和腺癌中水平比较,差异无统计学意义;同步放化疗后无CR患者,PR患者共15例,血清中CEA、SCC-Ag、CYFRA21-1和TK1水平较治疗前明显降低(P≤0.05),PD患者共25例,血清中CEA、SCC-Ag、CYFRA21-1和TK1水平较治疗前明显升高(P≤0.05),SD患者血清中CEA、SCC-Ag、CYFRA21-1和TK1水平较治疗前差异无统计学意义。结论Ⅲb期NSCLC同步放化疗后,血清中CEA、SCC-Ag、CYFRA21-1和TK1水平可作为评价疗效的指标,具有一定的临床价值。

Objective To study the level changes of tumor markers before and after concurrent chemo-radio- therapy in patients with Ⅲb NSCLC and to evaluate its curative effect. Methods 68 patients with Ⅲb NSCLC were selected as the treatment group from January 2014 to January 2016, and they were treated with concurrent chemo-radiotherapy. 1 month after 2 cycles, tumor markers were rechecked and the effect was evaluated. The healthy people were taken as the control group. Results Before treatment, the levels of CEA, SCC-Ag, CYFRA21-1 and TK1 in serum were significantly higher in the treatment group than in the control group, but the expression of NSE showed no statistical significance. After treatment, the levels of CEA, SCC-Ag, CYFRA21-1 and TK1 were significantly lower than before. The level of CEA in adenocarcinoma was significantly higher than in squamons cell carcinomas and the levels of SCC-Ag, CYFRA21-1 and TK1 were significantly higher in squamous carcinoma, but the level of NSE in squamous carcinoma and adenocarcinoma showed no significant difference. The levers of CEA, SCC-Ag, CYFRA21- 1 and TK1 in PR patients were significantly lower than before. The levers of CEA, SCC-Ag, CYFRA21-1 and TK1 in SD patients were not statistically significant. Conclusion The levers of CEA, SCC-Ag, CYFRA21-1 and TK1 in serum can be used as specific indexes to evaluate the effect of concurrent chemo-radiotherapy, which has a certain practical value.