肺癌患者血清CA724、Cyfra21-1及ProGRP水平与临床病理特征及预后的关系

Correlation of serum CA724,Cyfra21-1 and ProGRP levels with clinicopathological features and prognosis in patients with lung cancer

目的分析肺癌患者血清糖类抗原724(CA724)、细胞角蛋白19片段(Cyfra21-1)及胃泌素释放肽前体(ProGRP)水平与临床病理特征及预后的关系。方法选取2015年1月至2017年5月于安徽医科大学附属巢湖医院就诊的肺癌患者104例作为病例组,选取同期本院体检健康者50名作为对照组,对病例组随访60个月。采用电化学发光法检测两组血清CA724、Cyfra21-1及ProGRP水平,分析血清CA724、Cyfra21-1及ProGRP水平与肺癌患者临床病理特征的关系,并绘制生存曲线分析血清CA724、Cyfra21-1及ProGRP水平与患者预后的关系。随访期间,以复发、转移与死亡为预后不良,分析肺癌患者预后不良影响因素。结果病例组患者血清CA724、Cyfra21-1、ProGRP水平均高于对照组,差异具有统计学意义(t=8.140、22.139、38.862,P<0.05);TNM分期为Ⅲ和Ⅳ期、有淋巴转移、有远处转移肺癌患者血清CA724、Cyfra21-1、ProGRP水平均高于TNM分期为Ⅰ和Ⅱ期、无淋巴转移、无远处转移肺癌患者,差异具有统计学意义(t_(CA724)=5.695、8.078、6.572,t_(Cyfra21-1)=5.502、7.697、6.261,t_(ProGRP)=5.579、8.065、6.406,P<0.05);低血清CA724、Cyfra21-1或ProGRP水平患者累积生存率高于高血清CA724、Cyfra21-1或ProGRP水平,差异具有统计学意义(χ^(2)=9.838、7.916、6.890,P<0.05);TNM分期、淋巴结转移、血清CA724、Cyfra21-1、ProGRP水平为肺癌患者预后不良的影响因素(P<0.05)。结论肺癌患者血清CA724、Cyfra21-1及ProGRP水平均升高,高水平的CA724、Cyfra21-1及ProGRP与分期、转移及不良预后有关,或可作为肺癌患者预后评价的血清生物学指标。

Objective To analyze the association between serum levels of carbohydrate antigen 724(CA724),cytokeratin 19 fragment(Cyfra21-1),and gastrin releasing peptide precursor(ProGRP)and clinicopathological characteristics and prognosis of patients with lung cancer.Methods A total of 104 lung cancer patients who visited the Affiliated Chaohu Hospital of Anhui Medical University from January 2015 to May 2017 were selected as the case group,and 50 healthy individuals who underwent physical examination in the same period in the hospital were selected as the control group,and the case group was followed up for 60months.Serum CA724,CYFRA21-1 and ProGRP levels were measured by electrochemiluminescence assay in the two groups,the relationship between the serum CA724,CYFRA21-1 and ProGRP levels and the clinicopathological characteristics of lung cancer patients were analyzed.A survival curve was drawn to analyze the association between the serum CA724,CYFRA21-1 and ProGRP levels and the prognosis of patients.During the follow-up period,recurrence,metastasis and death were considered poor prognostic factors,and the poor prognostic factors of lung cancer patients were analyzed.Results The levels of serum CA724,CYFRA21-1,and Pro GRP in the case group were higher than than those in the control group(t=8.140,22.139,38.862,P<0.05).The serum CA724,CYFRA21-1,and Pro GRP levels were higher in lung cancer patients with TNM stagesⅢandⅣ,with lymphatic metastasis,and with distant metastasis than in lung cancer patients with TNM stagesⅠandⅡ,without lymphatic metastasis,and without distant metastasis,respectively(t_(CA724)=5.695,8.078,6.572,t_(Cyfra21-1)=5.502,7.697,6.261,t_(ProGRP)=5.579,8.065,6.406,P<0.05).The cumulative survival rate of patients with low serum CA724,CYFRA21-1 or Pro GRP levels was higher than that of patients with high serum CA724,CYFRA21-1 or Pro GRP levels with statistically significant differences(χ^(2)=9.838,7.916,6.890,P<0.05).TNM stage,lymph node metastasis,serum CA724,CYFRA21-1,Pro GRP levels were the influencing factors of poor prognosis of lung cancer patients(P<0.05).Conclusion Serum levels of CA724,CYFRA21-1 and Pro GRP were increased in lung cancer patients.High levels of CA724,CYFRA21-1 and Pro GRP were associated with stage,metastasis,and poor prognosis,or could be used as serum biological indicators for prognosis evaluation of lung cancer patients.