Ⅲ期非小细胞肺癌患者精确放疗前后血清CEA、SCC、NSE水平变化及与放疗疗效的关系研究

Changes of Serum CEA,SCC,NSE Levels in Patients with Stage Ⅲ Non-Small Cell Lung Cancer before and after Accurate Radiotherapy and the Relationship with Radiotherapy Efficacy

目的:研究Ⅲ期非小细胞肺癌(NSCLC)患者精确放疗前后血清癌胚抗原(CEA)、鳞状细胞癌相关抗原(SCC)、神经元特异性烯醇化酶(NSE)水平变化及与放疗疗效的关系。方法:选择2014年1月到2016年12月在亳州市人民医院肿瘤科就诊的60例Ⅲ期NSCLC患者纳入此次研究,其中鳞癌14例,腺癌26例,腺鳞癌20例。所有患者均实施4周的精确放疗,放疗后肿瘤标记物水平降低43例,升高17例。根据放疗疗效将患者分为有效组39例,无效组21例。对比不同病理类型的Ⅲ期NSCLC患者CEA、SCC、NSE水平,不同疗效组放疗前后CEA、SCC、NSE水平,并分析患者的肿瘤标记物水平变化与放疗疗效的关系。结果:腺癌Ⅲ期NSCLC患者的CEA、NSE水平高于鳞癌及腺鳞癌者,且腺鳞癌者又高于鳞癌者;SCC水平低于鳞癌及腺鳞癌者,且腺鳞癌者又低于鳞癌者(P<0.05)。放疗后有效组CEA、SCC、NSE水平均低于放疗前和无效组,而无效组CEA、SCC、NSE水平高于放疗前(P<0.05)。肿瘤标记物水平降低者的有效率高于升高者,差异有统计学意义(P<0.05)。结论:在实施精确放疗后治疗有效的Ⅲ期NSCLC患者,其血清CEA、SCC、NSE水平均呈现出明显的下降趋势,且与病理类型密切相关,临床上可重点关注上述指标水平,有助于患者的诊疗过程。

Objective： To study the changes of serum carcinoembryonic antigen（CEA）,squamous cell carcinoma-associated antigen（SCC）,neuron-specific enolase（NSE） levels in patients with stage III non-small cell lung cancer（NSCLC） before and after accurate radiotherapy and the relationship with radiotherapy efficacy. Methods： 60 patients with stage III NSCLC who were treated in the Oncology Department of Bozhou People＇s Hospital from January 2014 to December 2016 were enrolled in this study,and there were squamous cell carcinoma with 14 cases,adenocarcinoma with 26 cases,adenosquamous carcinoma with 20 cases. All patients were given accurate radiotherapy for 4 weeks,and the levels of tumor markers after radiotherapy were decreased with 43 case and increased with 17 cases. According to the radiotherapy efficacy,the patients were divided into effective group with 39 cases and invalid group with 21 cases. The levels of CEA,SCC and NSE in stage III NSCLC patients with different pathological types were compared,the levels of CEA,SCC and NSE before and after radiotherapy in different therapeutic groups were compared,and the relationship between the levels of tumor markers and radiotherapy efficacy was analyzed. Results： The levels of CEA and NSE in patients with stage III NSCLC of adenocarcinoma were higher than those in squamous cell carcinoma and adenosquamous carcinoma,and those in adenosquamous carcinoma were higher than that in squamous cell carcinoma,level of SCC was lower than that in squamous cell carcinoma and adenosquamous carcinoma,and those in adenosquamous carcinoma were lower than that in squamous cell carcinoma（P〈0.05）. After radiotherapy,the levels of CEA,SCC and NSE in the effective group were lower than those before radiotherapy and in the invalid group,but the levels of CEA,SCC and NSE in the invalid group were higher than that before radiotherapy（P〈0.05）. The effective rate of patients with tumor markers decreasing was significantly higher than patients with tumor markers increasing,and the difference was statistically significant（P〈0.05）. Conclusion： The levels of serum CEA,SCC,and NSE in stage III NSCLC patients with effective treatment after accurate radiotherapy are significantly decreased,and they are closely related to pathological types. In clinical,we can focus on the above index level and help the patient＇s diagnosis and treatment process.