CA125、CEA、CYFRA21-1检测在贝伐单抗联合TP方案治疗晚期非小细胞肺癌前后的表达及临床意义

The Expression and Clinical Significance of CA125,CEA and CYFRA21-1 in the Treatment of Advanced Non-small Cell Lung Cancer with Bevacizumab Combined with TP Chemotherapy

目的探讨CA125、CEA、CYFRA21-1检测在贝伐单抗联合TP方案治疗晚期非小细胞肺癌(NSCLC)前后的表达及临床意义。方法以2015年1月至2016年12月在我院确诊的晚期NSCLC患者90例作为研究对象,全部患者给予贝伐单抗联合TP方案进行治疗,共2个疗程,分别在患者化疗前后抽取静脉血,利用化学发光法测定血清中CA125、CEA、CYFRA21-1的水平,评价化疗前后患者CA125、CEA、CYFRA21-1的变化及三种肿瘤标志物与化疗疗效的关系。结果化疗前,CA125、CEA以及CYFRA21-1的阳性率在临床分期Ⅳ期患者人群中明显高于临床分期Ⅲ期的患者,在病理分型为腺癌的患者人群中明显高于鳞癌的患者,在转移部位≥2的患者人群中明显高于转移部位为1的患者,且上述差异均具有统计学意义(P<0.05)。化疗后临床治愈(CR)和部分缓解(PR)患者的CA125、CEA以及CYFRA21-1与化疗前相比均明显降低,差异具有统计学意义(P<0.05)。化疗后疾病恶化(PD)患者的CA125、CEA、CYFRA21-1水平均明显上升,且差异均具有统计学意义(P<0.05)。CA125、CEA以及CYFRA21-1检测对临床疗效变化及疗效评价的总体符合率分别为27.8%,46.7%和51.1%。结论 CA125、CEA以及CYFRA21-1水平变化与NSCLC化疗后的临床疗效密切相关,值得临床推广应用。

Objective To investigate the expression and clinical significance of CA125 ,CEA and CYFRA21-1 in the treatment of advanced non-small cell lung cancer with bevacizumab combined with TP chemotherapy. Methods A total of 90 advanced NSCLC patients diagnosed in our hospital from January 2015 to December 2016 were selected as study subjects. All patients were given bevacizumab combined with TP chemotherapy for 2 courses. Venous blood was collected before and after chemotherapy and tested using chemiluminescence method for serum CA125, CEA and CYFRA21-1 content. The changes of the three indicators before and after chemotherapy were evaluated and the association between the changes and chemotherapeutic effect were evaluated. Results Before chemotherapy, the positive rate of CA125, CEA and CYFRA21-1 in clinical stage IV patients, the pathological type of adenocarcinoma patients and metastatic sites more than 2 were significantly higher than those of clinical stage III patients, the pathological type of squamous cell carcinoma and metastatic sites 1. The differences were statistically significant（ P 〈 0.05 ）. After chemotherapy ,the levels of CA125 ,CEA, and CYFRA21-1 in patients with clinical efficacy of cure（CR） and partial remission （PR） were significantly lower than those before chemotherapy, and the differences were statistically significant（ P 〈 0.05 ）. After chemotherapy,the levels of CA125, CEA and CYFRA21-1 in patients with disease progression （PD） significantly increased （ P 〈 0.05 ）. The overall agreement rates of clinical efficacy of CA125, CEA and CYFRA21-1 and clinical efficacy of tumor were 27.8 %, 46.7 % and 51.1% respectively. Conclusion The changes of CA125, CEA and CY RA21-1 levels are positively related to the clinical efficacy of NSCLC after chemotherapy. The three indicators are worthy to be used in clinical.