血清NSE下降幅度与晚期小细胞肺癌化疗疗效相关性分析

Analysis of correlation between the decrease of serum NSE and chemotherapy response in advanced small cell lung cancer

目的:分析晚期小细胞肺癌患者血清神经元特异性烯醇化酶(NSE)变化与肿瘤影像学改变的关系,探讨血清NSE与晚期小细胞肺癌化疗疗效的相关性。方法:选取在南京市脑科医院胸科院区呼吸内科和江苏省肿瘤医院肿瘤内科住院治疗的70例广泛期小细胞肺癌患者,均经病理学或细胞学确诊。入选患者检测血清NSE均在化疗前一周,疗效评价均为化疗2周期后按照实体瘤的疗效评价标准(RECIST)标准进行评估,探讨血清NSE下降幅度及下降率与晚期小细胞肺癌疗效评价的相关性。结果:血清NSE与小细胞肺癌患者在患者年龄、性别、TNM分期方面均无统计学差异(P>0.05),血清NSE在化疗近期疗效上有统计学显著性差异(P<0.05)。部分缓解(PR)组、疾病稳定(SD)组患者所测得的血清NSE中位数分别为:3.55 ng·mL^-1,2.39 ng·mL^-1;临床获益组患者(PR+SD)所测血清NSE中位数为3.40 ng·mL^-1;PD组患者所测血清NSE中位数为-5.31 ng·mL^-1,PR患者的血清NSE下降幅度、下降率均高于SD及疾病进展(PD)的患者。临床获益组(PR+SD)患者血清NSE下降幅度、下降率均高于获得PD组的血清肿瘤标志物趋势。结论:血清NSE与晚期小细胞肺癌化疗疗效具有一定的相关性,NSE下降幅度及下降率可以辅助及时评价晚期小细胞肺癌化疗疗效。

OBJECTIVE To analyze the relationship between the changes of serum neuron specific enolase(NSE)and imaging changes in patients with advanced small cell lung cancer(NSCLC),and to explore the correlation between serum NSE and the efficacy of chemotherapy in advanced NSCLC.METHODS Seventy patients with extensive stage small cell lung cancer who were hospitalized in the Department of Respiratory Medicine,Chest Hospital,Nanjing Brain Hospital and the Department of Medical Oncology,Jiangsu Cancer Hospital were selected and diagnosed by pathology or cytology.Serum NSE was measured in all selected patients one week before chemotherapy,and the efficacy evaluation was assessed according to RECIST criteria after 2 cycles of chemotherapy to investigate the correlation between the decrease and rate of serum NSE and the efficacy evaluation of advanced small cell lung cancer.RESULTS There was no significant difference in age,sex and TNM stage between patients with serum NSE and small cell lung cancer(P>0.05).There was significant difference in short-term efficacy of chemotherapy between patients with serum NSE and small cell lung cancer(P<0.05).The median measured serum NSE was 3.55 ng·mL^-1 and 2.39 ng·mL^-1 in the PR and SD groups,respectively;The median measured serum NSE was 3.40 ng·mL^-1 in the clinical benefit group(PR+SD)and-5.31 ng·mL^-1 in the PD group,and the decrease and decrease in serum NSE were higher in the PR patients than in the SD and PD patients.The decrease of serum NSE in patients with clinical benefit(PR+SD)was higher than that in patients with PD.CONCLUSION Serum NSE has certain correlation with the efficacy of chemotherapy in advanced small cell lung cancer.The decrease range and rate of NSE can help to evaluate the efficacy of chemotherapy in advanced small cell lung cancer in time.