肺癌患者化疗前后外周血肿瘤标志物水平变化的临床价值

Clinical Value of Peripheral Blood Tumor Markers in Patients with Lung Cancer before and after Chemotherapy

目的对肺癌患者化疗前后外周血内肿瘤标志物水平改变进行分析。方法随机选取50例肺癌患者,给予紫杉醇类或联合顺铂方案化疗2个周期,采用放射免疫技术对不同病理类型组化疗前后外周血内肿瘤标志物CEA、NSE、CYFRA 21-1水平进行监测,并结合化疗前后肺部CT影像学变化分析化疗前各病理类型血清肿瘤外周血内肿瘤标志物水平。结果 50例患者经2个周期化疗后,行CT影像学检测评估,肿块PR+CR者38例,NC+PD者12例。化疗前,腺癌组血清CEA水平显著高于鳞癌组和小细胞肺癌组;鳞癌组CYFRA 21-1水平显著高于腺癌组和小细胞肺癌;小细胞肺癌组NSE水平显著高于腺癌组和鳞癌组,数据对比差异均具有统计学意义(P<0.05)。腺癌组(CR+PR)化疗后CEA水平显著低于化疗前;鳞癌组(CR+PR)化疗后CYFRA 21-1水平显著低于化疗前;小细胞肺癌组(CR+PR)化疗后NSE水平显著低于化疗前,数据对比差异均具有统计学意义(P<0.05)。结论通过检测外周血内肿瘤标志物CEA、NSE、CYFRA 21-1水平改变可用于化疗疗效判定,具有简便、经济的特点。

Objective To study the peripheral blood levels of tumor markers in lung cancer patients after chemotherapy change. Methods 50 cases of lung cancer received capsulation or palliate chemotherapy 2 cycles, using radioimmunoassay tech- nique for different pathological types of peripheral blood before and after chemotherapy, the tumor markers CEA, NSE, CYFRA 21- 1 levels were monitored changes in lung CT imaging analysis of the various pathological types of chemotherapy before the tumor peripheral serum levels of tumor markers before and after combined chemotherapy. Results 50 patients underwent 2 cycles of chemotherapy and were evaluated by CT imaging. There were 38 patients with PR ＋ CR and 12 patients with NC ＋ PD. The level of serum CEA in adenocarcinoma group was significantly higher than that in squamous cell carcinoma group and small cell lung cancer group. The CYFRA 21-1 level in squamous cell carcinoma group was significantly higher than that in adenocareinoma group and small cell lung cancer group;the NSE level in small cell lung cancer group was significantly higher than that in adeno- carcinoma group Cancer group and squamous cell carcinoma group, the data had statistically significant difference（ P 〈 0.05 ）. The level of CYFRA 21-1 in patients with squamous cell carcinoma（ CR ＋ PR） after chemotherapy was significantly lower than that before chemotherapy（ CR ＋ PR） ,and the level of CYFRA 21-1 was significantly lower in patients with squamous cell carcinoma （ CR ＋ PR） NSE level was significantly lower than before chemotherapy, the data had statistically significant difference （ P 〈 0.05 ）. Conclusion The detection of peripheral blood tumor markers CEA, NSE, CYFRA 21-1 level change can determine the efficacy of chemotherapy, with simple and economic characteristics.