小细胞肺癌一线治疗后疗效及早期复发的预测分析

Predictive analysis of the efficacy and early recurrence of small cell lung cancer after first-line treatment

目的探讨神经元特异性烯醇化酶(NSE)、胃泌素释放肽前体(pro-GRP)、癌胚抗原(CEA)、乳酸脱氢酶(LDH)、中性粒细胞数在小细胞肺癌(SCLC)疗效及早期复发中的预测价值。方法选择72例SCLC初治患者,分析化疗前后各指标(NSE、pro-GRP、CEA、LDH、中性粒细胞数)及其下降率与疗效的相关性,比较早期复发和无早期复发患者化疗后各指标的下降率,采用Logistic回归模型分析SCLC早期复发的影响因素。结果化疗后NSE、pro-GRP、LDH下降率与疗效均呈正相关(P﹤0.01)。早期复发患者化疗后血清NSE、pro-GRP、LDH下降率均低于无早期复发患者,差异均有统计学意义(P﹤0.05)。临床分期、化疗后NSE水平、化疗前CEA水平均是SCLC早期复发的独立危险因素(P﹤0.05)。结论NSE、pro-GRP、LDH、CEA对SCLC的化疗疗效及早期复发具有一定的预测价值。

Objective To investigate the predictive value of neuron specific enolase(NSE),pro-gastrin-releasing peptide(pro-GRP),carcinoembryonic antigen(CEA),lactate dehydrogenase(LDH),and neutrophil count in detecting the efficacy and early recurrence of small cell lung cancer(SCLC).Method A total of 72 cases of SCLC patients who had no prior specific treatment were included in the study,the association between efficacy and each indicator(NSE,pro-GRP,CEA,LDH,neutrophil count)and the corresponding decrease rate was analyzed,besides,the decrease rate for each indicator among patients with early recurrence and non-early recurrence were compared,additionally,Logistic regression model was employed to determine the factors associated with the early recurrence of SCLC.Result After chemotherapy,the decrease rate of NSE,pro-GRP,and LDH were all positively correlated with efficacy(P<0.01).Lower decrease rate of serum NSE,pro-GRP and LDH were noted in patients with early recurrence compared to those with non-early recurrence,showing statistically significant differences(P<0.05).Clinical stage,post-chemotherapy NSE level,pre-chemotherapy CEA level were independent risk factors for early recurrence of SCLC(P<0.05).Conclusion NSE,pro-GRP,LDH,and CEA are fairly useful in predicting the efficacy and early recurrence of SCLC.