血清癌胚抗原和细胞角质蛋白19片段抗原21-1水平对老年晚期非小细胞肺癌患者预后的影响

Effect of serum carcinoembryonic antigen and cyto-keratin 19 fragment antigen 21-1 levels on prognosis in elderly patients with advanced non-small cell lung cancer

目的探讨血清癌胚抗原(CEA)、细胞角质蛋白19片段抗原21-1(CYFRA21-1)水平对老年晚期非小细胞肺癌(NSCLC)患者化疗效果及预后的影响。方法收集13 8例接受吉西他滨联合顺铂化疗方案治疗的老年晚期NSCLC患者的病历资料,记录其化疗情况,并比较不同化疗效果患者的血清CEA、CYFRA21-1水平以及不同血清CEA和CYFRA21-1水平患者的预后情况,并采用Cox回归模型分析老年NSCLC患者预后的影响因素。结果 138例老年晚期NSCLC患者中,化疗有效患者共52例,化疗无效患者共86例。化疗有效患者的卡氏功能状态(KPS)评分明显高于化疗无效患者(P <0.01);化疗有效患者中TNM分期为Ⅳ期的患者比例明显低于化疗无效患者(P <0.01)。治疗前后,化疗有效患者血清CEA和CYFRA21-1水平的变化值均明显高于化疗无效患者(P <0.01)。CEA水平的变化值≥3.50 ng/L、CYFRA21-1水平的变化值≥1.90μg/L患者的中位总生存时间长于CEA水平的变化值<3.50 ng/L、CYFRA21-1水平的变化值<1.90μg/L的患者(P<0.05)。Cox比例风险回归分析结果显示,TNM分期、KPS评分、血清CEA水平的变化值、血清CYFRA21-1水平的变化值是老年晚期NSCLC患者预后的影响因素(P <0.05)。结论 TNM分期、KPS评分、血清CEA水平的变化值、血清CYFRA21-1水平的变化值是老年晚期NSCLC患者预后的影响因素。

Objective To investigate the effect of serum carcinoembryonic antigen(CEA)and cyto-keratin 19 fragment antigen 21-1(CYFRA21-1)levels on the prognosis of elderly patients with advanced non-small cell lung cancer(NS CL C).Method One hundred and thirty-eight elderly patients with advanced NSCLC which were treated with gemcitabine combined with cisplatin were selected,recorded their chemotherapy,and compare the different effect of chemotherapy in patients with serum CEA,CYFRA21-1 level and different levels of serum CEA and CYFRA21-1 the patient s prognosis.Cox regression model was used to analyze the prognostic factors of elderly patients with advanced NSCLC.Result Among the 138 elderly patients with advanced NSCLC,52 patients were effective and 86 patients were ineffective.The Karnofsky performance status(KPS)scores of patients with effective chemotherapy was significantly higher than that of patients with ineffective chemotherapy(P<0.01).The proportion of the patients with TNM stageⅣin effective chemotherapy was significantly lower than that in the patients with ineffective chemotherapy(P<0.01).Before and after treatment,the changes of serum CEA and CYFRA21-1 levels in the patients with effective chemotherapy were significantly higher than those in the patients with ineffective chemotherapy(P<0.01).The median overall survival time of patients with CEA level change value≥3.50 ng/L and CYFRA21-1 level change value≥1.90 ug/L were longer than those with CEA level change value<3.50 ng/L and CYFRA21-1 level change value<1.90μg/L(P<0.05).Cox proportional hazard regression analysis showed that TNM stage,KPS score,the change of serum CEA level and the change of serum CYFRA21-1 level were the prognostic factors of elderly patients with advanced NSCLC(P<0.05).Conclusion TNM stage,KPS score,the change of serum CEA level and the change of serum CYFRA21-1 level are the prognostic factors of elderly patients with advanced NSCLC.