非小细胞肺癌组织中GSTP1、CYFRA21-1及SCC-Ag水平的变化及其临床意义

Changes of GSTP1,CYFRA21-1 and SCC-Ag Levels in NSCLC and Their Clinical Significance

目的探讨非小细胞肺癌(NSCLC)组织中谷胱甘肽硫转移酶P1(GSTP1)、细胞角质蛋白19片段抗原21-1(CYFRA21-1)、人鳞状细胞癌相关抗原(SCCAg)水平变化及其临床意义。方法选取NSCLC患者97例,另选取健康体检者97例为对照组,检测上述3项指标,并随访1年以上,分析上述标志物指标与生存时间的相关性。结果观察组三项指标水平[(39.58±16.93)ng/ml、(8.42±3.11)ng/ml、(5.28±2.22)ng/ml]高于对照组[(3.92±1.59)ng/ml、(1.57±0.45)ng/ml、(0.95±0.63)ng/ml](P<0.05);腺癌患者GSTP1[(44.58±16.25)ng/ml]高于腺鳞癌患者[(33.69±15.24)ng/ml],腺鳞癌患者高于鳞癌患者[(23.95±14.57)ng/ml];鳞癌患者CYFRA21-1[(12.47±2.85)ng/ml]、[SCC-Ag(8.35±2.49)ng/ml]高于腺鳞癌患者[(10.36±2.29)ng/ml、(6.17±2.35)ng/ml],腺鳞癌患者高于腺癌患者[(4.25±2.91)ng/ml、(3.13±2.67)ng/ml](P<0.05);生存时间<1年患者三项指标[(48.57±18.27)ng/ml、(15.38±5.92)ng/ml、(9.26±3.55)ng/ml]高于生存时间>1年患者[(27.69±23.58)ng/ml、(6.24±3.56)ng/ml、(3.38±1.59)ng/ml](P<0.05);三项指标单独及联合预测生存<1年的AUC值为0.850、0.749、0.864、0.921(P<0.05),敏感度为84.25%、76.62%、89.76%、93.14%,特异度为79.63%、75.85%、82.56%、88.23%;Logistic分析显示,GSTP1(OR=4.692,95%CI:1.853~7.356)、CYFRA21-1(OR=3.953,95%CI:1.149~6.460)、SCC-Ag(OR=3.521,95%CI:1.035~5.979)是生存时间的影响因素(P<0.05)。结论GSTP1、CYFRA21-1、SCC-Ag与NSCLC恶性程度有关,可较准确预测NSCLC患者预后。

Objective To investigate the changes and clinical significance of glutathione thitransferase P1(GSTP1),cytokeratinin-19 fragment antigen 21-1(CYFRA21-1)and human squamous cell carcinoma associated antigen(SCCAg)in patients with non-small cell lung cancer(NSCLC).Methods 97 NSCLC patients were selected as the observation group and 97 healthy subjects as the control group.The above 3 indicators were detected and followed up for more than 1 year to analyze the correlation between the above markers and survival time.Results GSTP1[(39.58±16.93)ng/ml],CYFRA21-1[(8.42±3.11)ng/ml]and SC-AG[(5.28±2.22)ng/ml]in the observation group were higher than those in the control group[(3.92±1.59)ng/ml]and[(1.57±0.45)ng/ml],(0.95±0.63 ng/ml)(P<0.05);GSTP1 in adenocarcinoma patients was[(44.58±16.25)ng/ml],in adeno-squamous carcinoma patients was(33.69±15.24ng/ml),and in squamous carcinoma patients[(23.95±14.57)ng/ml](P<0.05).CYFRA21-1[(12.47±2.85)ng/ml]and SCC-Ag[(8.35±2.49)ng/ml]in squamous carcinoma patients were higher than those in adeno-squamous carcinoma patients[(10.36±2.29)ng/ml],[(6.17±2.35)ng/ml].The latter higher than those in adenocarcinoma patients[(4.25±2.91)ng/ml]and[(3.13±2.67)ng/ml](P<0.05).Three kinds of indicators[(48.57±18.27)ng/ml],[(15.38±5.92)ng/ml],[(9.26±3.55)ng/ml]in patients with survival time<1 year were higher than those with survival time>1 year[(27.69±23.58)ng/ml],[(6.24±3.56)ng/ml],[(3.38±1.59)ng/ml](P<0.05);The AUC values of survival<1 year were 0.850,0.749,0.864,0.921(P<0.05),the sensitivity was 84.25%,76.62%,89.76%,93.14%,and the specificity was 79.63%,75.85%,82.56%,88.23%.Logistic analysis sho-wed that GSTP1(OR=4.692,95%CI:1.853~7.356),CYFRA21-1(OR=3.953,95%CI:1.149~6.460),SCC-Ag(OR=3.521,95%CI:1.035~5.979)were influencing factors for survival time<1 year(P<0.05).Conclusion GSTP1,CYFRA21-1 and SCC-Ag are related to the level of malignancy of NSCLC and can accurately predict the prognosis of patients with NSCLC.