CEA、AFP及CYFRA21⁃1在NSCLC中的表达及与病理特征和预后的关系

Relationship between the expression of CEA,AFP and CYFRA21⁃1 in NSCLC and pathological characteristics and prognosis

目的分析血清癌胚抗原(CEA)、甲胎蛋白(AFP)、细胞角蛋白19片段(CYFRA21⁃1)在非小细胞肺癌(NSCLC)患者中的表达及与病理特征和预后的关系。方法收集2018年9月至2020年9月首都医科大学附属北京世纪坛医院收治的92例NSCLC患者(NSCLC组),另选取同期89例健康体检志愿者(对照组)。收集患者一般资料,比较两组血清CEA、AFP、CYFRA21⁃1表达水平,分析CEA、AFP、CYFRA21⁃1与NSCLC病理特征和预后的关系。结果NSCLC组患者血清中CEA、AFP、CYFRA21⁃1表达水平均明显高于对照组,差异有统计学意义(P<0.05)。Ⅲ~Ⅳ期、低分化、淋巴结转移者CEA、AFP、CY⁃FRA21⁃1阳性率明显高于I⁃II期、中高分化、无淋巴结转移者,差异有统计学意义(P<0.05),在不同年龄、性别、病理类型之间CEA、AFP、CYFRA21⁃1阳性率比较差异无统计学意义(P>0.05)。92例患者根据预后情况分为预后良好组71例,预后不良组21例。TNM分期、组织分化、CEA、AFP、CYFRA21⁃1为影响NSCLC患者预后的单因素(P<0.05)。经多元Logistic回归分析可知,TNM分期、组织分化、CEA、AFP、CYFRA21⁃1为影响NSCLC患者预后不良的独立危险因素(P<0.05)。结论血清CEA、AFP、CYFRA21⁃1在NSCLC患者中的表达均上调,与患者病理特征和预后密切相关,可能可作为预后评估的有效指标。

Objective To analyze the relationship between the expression of serum carcinoembryon⁃ic antigen(CEA),alpha fetoprotein(AFP)and cytokeratin fragment(CYFRA21⁃1),pathological characteristics and prognosis in patients with non⁃small cell lung cancer(NSCLC).Methods 92 NSCLC patients(NSCLC group)admitted to Beijing University of Century Tank Hospital from September 2018 to September 2020 were collected,and 89 volunteers(control group)who had physical examination during the same period in this hospi⁃tal were selected.The general data of patients were collected,and the expression levels of CEA,AFP,CY⁃FRA21⁃1 in the serum of different groups were compared,and the relationship between the levels of CEA,AFP and CYFRA21⁃1 and the pathological characteristics and prognosis of NSCLC was analyzed.Results The expression levels of CEA,AFP,and CYFRA21⁃1 in the serum of NSCLC patients were significantly higher than those in the control group(P<0.05).The positive rates of CEA,AFP,and CYFRA21⁃1 in patients with stageⅢ~Ⅳ,poor differentiation,and lymph node metastasis were significantly higher than those of stageⅠ~Ⅱ,moderate and high differentiation,and no lymph node metastasis(P<0.05).There was no statistically significant difference in the positive rates of CEA,AFP,and CYFRA21⁃1 among different age,gender,pathological type(P>0.05).According to the prognosis,92 patients were divided into a good prognosis group(71 cases)and a poor prognosis group(21 cases).TNM staging,tissue differentiation,CEA,AFP,CYFRA21⁃1 and NSCLC were the single factors affecting the prognosis of NSCLC patients(P<0.05).Multivariate logistic regression analysis showed that TNM staging,tissue differentiation,CEA,AFP,and CYFRA21⁃1 were independent risk factors affecting the poor prognosis of NSCLC patients(P<0.05).Conclusion The expressions of serum CEA,AFP,and CYFRA21⁃1 in NSCLC patients are all up⁃regulated,which are closely related to the pathological characteristics and prognosis of patients and may be effective indicators for prognostic evaluation.