血清CEA、CA211水平与晚期非小细胞肺癌靶向治疗患者疗效、预后的关系及其诊断价值分析

The Relationship between Serum CEA and CA211 Levels and the Efficacy,Prognosis and Diagnostic Value of Targeted Therapy for Advanced Non-small Cell lung Cancer

目的:探讨血清癌胚抗原(CEA)、细胞角蛋白19片段(CA211)水平与晚期非小细胞肺癌(NSCLC)靶向治疗患者疗效、预后的关系,并分析其对治疗有效性的诊断价值。方法:选取2013年6月到2017年8月期间在广西医科大学附属肿瘤医院接受治疗的晚期NSCLC患者90例,所有患者均采用盐酸厄洛替尼片进行治疗。记录所有患者治疗后的临床疗效,根据治疗效果将患者分为有效组和无效组,比较不同治疗效果患者的血清CEA、CA211水平,分析血清CEA、CA211水平与患者无进展生存期(PFS)的关系,并分析患者血清CEA、CA211单独检测和联合检测对治疗有效性的诊断价值。结果:靶向治疗后,90例晚期NSCLC患者的总有效率为44.44%。治疗后,有效组的血清CEA、CA211水平明显低于治疗前,无效组的血清CEA、CA211水平明显高于治疗前(P<0.05),有效组的血清CEA、CA211水平明显低于无效组(P<0.05)。CEA<15 ng/mL的患者PFS明显短于CEA<15 ng/mL的患者(P<0.05),CA211≥5 ng/mL的患者PFS明显短于CA211<5 ng/mL的患者(P<0.05),血清CEA、CA211联合检测的敏感度高于CEA、CA211单独检测(P<0.05)。结论:CEA和CA211水平与晚期NSCLC靶向治疗患者疗效、预后有关,且血清CEA、CA211联合检测可提高靶向治疗效果评价的敏感度。

Objective: To investigate the relationship between serum carcinoembryonic antigen(CEA) and cytokeratin 19 fragment(CA211) levels and the efficacy and prognosis of patients with advanced non-small cell lung cancer(NSCLC), and to analyze its diagnostic value for therapeutic effectiveness. Methods: 90 patients with advanced NSCLC who were treated in The Affiliated Cancer Hospital of Guangxi Medical University from June 2013 to August 2017 were enrolled. All patients were treated with erlotinib hydrochloride tablets. The clinical efficacy of all patients after treatment was recorded. According to the treatment effect, the patients were divided into effective group and ineffective group. The serum CEA and CA211 levels of patients with different therapeutic effects were compared. The relationship between serum CEA and CA211 levels and patient progression-free survival(PFS) was analyzed. The diagnostic value of serum CEA and CA211 indicators in patients with serum alone and combined detection was evaluated. Results: After targeted therapy, the total effective rate of 90 patients with advanced NSCLC was 44.44%. After treatment, the levels of serum CEA and CA211 in the effective group were significantly lower than those before treatment. The levels of serum CEA and CA211 in the ineffective group were significantly higher than those before treatment(P <0.05). The serum CEA and CA211 levels in the effective group were significantly lower than those in the ineffective group(P<0.05). PFS in patients with CEA<15 ng/mL was significantly shorter than that PFS in patients with CEA<15 ng/mL(P<0.05). PFS in patients with CA211≥5 ng/mL was significantly shorter than PFS in patients with CA211<5 ng/mL(P<0.05). The sensitivity of combined detection of serum CEA and CA211 was higher than that of CEA and CA211 alone(P<0.05). Conclusion: The levels of CEA and CA211 are related to the efficacy and prognosis of patients with advanced NSCLC therapy, and the combined detection of serum CEA and CA211 can improve the sensitivity of targeted therapy evaluation.