CEA水平在晚期非小细胞肺癌预后中的作用

The role of CEA level in the prognosis of advanced non-small cell lung cancer

目的:探讨血清癌胚抗原(CEA)水平在晚期非小细胞肺癌(NSCLC)中预后判断的意义。方法:收集晚期NSCLC患者324例,分析临床病理特征与治疗前基线CEA水平的关系。单因素、多因素分析影响患者3年总生存期(overall survival,OS)的因素。绘制Kaplan-Meier生存曲线,分析基线CEA水平及治疗后CEA变化对3年OS和无进展生存期(progression-free survival,PFS)的影响。结果:晚期NSCLC患者治疗前CEA基线水平与年龄、吸烟及病理分型有关。单因素分析显示患者性别、吸烟、病理分型及治疗后CEA变化与3年OS有关。多因素分析显示,治疗后CEA上升是判断预后不良的因素(HR=1.804,P=0.001)。生存曲线分析显示,治疗前后CEA均正常患者及治疗后CEA下降患者的3年OS和PFS好于治疗后CEA上升患者,差异均具有统计学意义(P<0.05)。结论:治疗前CEA基线水平对患者OS及PFS无影响,2~3个周期规范治疗后CEA下降患者预后较好,而CEA上升的患者预后最差。

Objective:To investigate the prognostic significance of CEA in advanced non-small cell lung cancer(NSCLC).Methods:A total of 324 patients with advanced NSCLC were enrolled to analyze the relationship between clinicopathological features and baseline CEA level before treatment.Univariate and multivariate analyses were used to analyze the factors affecting patients’3-year overall survival(OS).Kaplan Meier curve was used to analyze the effect of baseline CEA level and CEA changes after treatment on 3-year OS and progression-free survival(PFS).Results:The baseline level of CEA in patients with advanced NSCLC was related to age,smoking,and pathological type.Univariate analysis showed that gender,smoking,pathological type,and the change of CEA after treatment were related to the 3-year OS.Multivariate analysis showed that the increase of CEA after treatment is a factor to judge the poor prognosis.The survival curve showed that the 3-year OS and PFS of patients with normal or reduced CEA after treatment were better than patients with increased CEA.Conclusion:From the above,the baseline level of CEA prior treatment had no effect on the 3-year OS and PFS,but after 2~3 cycles of standardized treatment,the prognosis of patients with decreased CEA was better than those with increased CEA.