术前细胞角蛋白19片段联合癌胚抗原检测对T2期非小细胞肺癌淋巴结转移的评估价值

Preoperative cytokeratin fragment 19 combined with carcinoembryonic antigen assay to assess the risk of lymph node metastasis in T2 non-small cell lung cancer

目的探讨术前细胞角蛋白19片段(cytokeratin fragment 19,CYFRA21-1)联合癌胚抗原(carcinoembryonic antigen,CEA)检测对T2期非小细胞肺癌患者淋巴结转移的预测价值。方法回顾性分析2020年1月至2022年10月在首都医科大学附属北京胸科医院接受手术治疗的448例T2期非小细胞肺癌患者的临床病理资料,根据术前肿瘤标志物CYFRA21-1、CEA的表达水平将其分为高表达组(CYFRA21-1≥6ng/ml或CEA≥6ng/ml,168例)和低表达组(CYFRA21-1<6ng/ml且CEA<6ng/ml,280例),比较两组患者的性别、年龄、吸烟史、病理类型、肿瘤大小及位置、淋巴结转移发生率和侵及程度。结果高表达组淋巴结转移发生率为51.19%(86/168),明显高于低表达组的28.21%(79/280),差异有显著性(P<0.001)。进一步分析显示肿瘤标志物高表达率在N2组为54.74%(52/95),N1组为48.57%(34/70),N0组为28.98%(82/283),不同淋巴结侵及程度组间比较差异均有显著性(P<0.001)。结论CYFRA21-1和CEA表达水平与T2期非小细胞肺癌淋巴结转移的发生率和侵及程度相关,术前检测CYFRA21-1和CEA可评估T2期非小细胞肺癌患者的淋巴结转移风险,对术中有针对性的淋巴结清扫及术后优化辅助治疗具有重要的参考价值。

Objective To analyze the predictive value of preoperative CYFRA21-1 combined with CEA assay for lymph node metastasis in T2non-small cell lung cancer patients.Method A retrospective analysis was performed on the clinicopathological data of 448 patients with T2non-small cell lung cancer who underwent surgery in our hospital from January 2020 to October 2022.According to the expression level of preoperative tumor markers,they were divided into high-expression group(CYFRA21-1≥6ng/ml or CEA≥6ng/ml,n=168)and low-expression group(CYFRA21-1<6ng/ml and CEA<6ng/ml,n=280).The gender,age,smoking history,pathological type,tumor size and location were recorded respectively.The incidence and extent of lymph node metastasis were compared between the two groups.Result The incidence of lymph node metastasis in the high-expression group was 51.19%(86/168),significantly higher than that of lowexpression group 28.21%(79/280),the difference was statistically significant(P<0.001).Further analysis showed that the high expression rate of certain tumor markers was 54.74%(52/95)in the N2group,48.57%(34/70)in the N1group,and 28.98%(82/283)in the No group,and the difference among the groups was statistically significant(P<0.001).Conclusion The expression of CYFRA21-1 and CEA was significantly correlated with the incidence and extent of lymph node metastases.Therefore,preoperative CYFRA21-1 combined with CEA detection can evaluate the risk of lymph node metastasis in patients with T2non-small cell lung cancer,and has important clinical reference value for intraoperative targeted lymph node dissection and optimization postoperative adjuvant therapy.