肺癌患者血清肿瘤标志物、EGFR、NSE、IL-6、TNF-α表达及与病理和预后的关系

Expressions of serum tumor markers,EGFR,NSE,IL⁃6 and TNF⁃αin patients with lung cancer and relationship with pathology and prognosis

目的研究肺癌患者血清肿瘤标志物、表皮生长因子受体(EGFR)、神经元特异性烯醇化酶(NSE)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)表达及与病理和预后的关系。方法收集2019年1月至2023年1月于洛阳石化医院肿瘤内科治疗的83例肺癌患者的病例资料,以其为观察组,同时收集同期于本院体检的健康志愿者46名为对照组。比较两组受检者血清肿瘤标志物[肿瘤相关抗原125(CA125)、人附睾蛋白4(HE4)、癌胚抗原(CEA)及鳞状细胞癌相关抗原(SCC)]、EGFR-mRNA、NSE、IL-6及TNF-α水平,并比较不同病理分型肺癌患者的上述指标表达情况,分析其与预后的关系。结果观察组患者血清CA125、HE4、CEA、SCC、EGFR-mRNA、NSE、IL-6及TNF-α水平均高于对照组,差异有统计学意义(t=14.276、12.298、15.879、8.352、27.388、5.713、26.582、12.823,P<0.05);肺癌患者血清CA125、SCC水平比较:鳞癌组>腺癌组>小细胞肺癌组,差异有统计学意义(P<0.05);血清HE4水平比较:腺癌组>鳞癌组>小细胞肺癌组,差异有统计学意义(P<0.05);血清CEA水平比较:腺癌组>小细胞肺癌组>鳞癌组,差异有统计学意义(P<0.05);血清NSE水平比较:小细胞肺癌组>腺癌组>鳞癌组,差异有统计学意义(P<0.05);预后不良组患者血清CA125、HE4、CEA、SCC、EGFR-mRNA、NSE、IL-6及TNF-α水平均较预后良好组高,差异有统计学意义(P<0.05);肺癌患者血清NSE水平预测肺癌预后不良的效能最高,当其截断值>14.15 ng/mL时,曲线下面积(AUC)为0.830。结论肺癌患者血清肿瘤标志物、EGFR-mRNA、NSE、IL-6及TNF-α呈高表达,其中肿瘤标志物及NSE与肺癌病理分型具有相关性,可作为预测肺癌预后不良的有效指标。

Objective To study the expressions of serum tumor markers,epidermal growth factor receptor(EGFR),neuron specific enolase(NSE),interleukin⁃6(IL⁃6)and tumor necrosis factor⁃α(TNF⁃α)in patients with lung cancer and their relationship with pathology and prognosis.Methods Case data from 83 patients with lung cancer in the Department of Medical Oncology of Luoyang Petrochemical Hospital were col⁃lected from January 2019 to January 2023.These patients were designated as the observation group.46 healthy volunteers who underwent physical examinations at the hospital during the same period were collected as the control group.Serum tumor markers[carbohydrate antigen 125(CA125),human epididymal protein 4(HE4),carcinoembryonic antigen(CEA),and squamous cell carcinoma associated antigen(SCC)],EGFR⁃mRNA,NSE,IL⁃6,and TNF⁃αwere compared between the two groups,and the expressions of these indicators in lung cancer patients with different pathological subtypes were compared,and their relationship with prognosis was analyzed.Results The levels of serum CA125,HE4,CEA,SCC,EGFR⁃mRNA,NSE,IL⁃6,and TNF⁃αin the observation group were higher than those in the control group(t=14.276,12.298,15.879,8.352,27.388,5.713,26.582,12.823,P<0.05).The levels of serum CA125 and SCC in lung cancer patients were ranked as follows:squamous cell carcinoma group>adenocarcinoma group>small cell lung cancer group(P<0.05),and serum HE4 level in lung cancer patients was manifested as adenocarcinoma group>squamous cell carcinoma group>small cell lung cancer group(P<0.05),and serum CEA level showed adenocarcinoma group>small cell lung cancer group>squamous cell carcinoma group(P<0.05).A comparison of serum NSE level revealed small cell lung cancer group>adenocarcinoma group>squamous cell carcinoma group(P<0.05).Furthermore,the levels of serum CA125,HE4,CEA,SCC,EGFR⁃mRNA,NSE,IL⁃6,and TNF⁃αwere higher in the poor prog⁃nosis group than those in the good prognosis group(P<0.05).The efficiency of serum NSE in predicting a poor prognosis for lung cancer was found to be the highest.When the cutoff value of serum NSE was greater than 14.15 ng/mL,the area under the curve(AUC)was 0.830.Conclusion Serum tumor markers,such as EGFR⁃mRNA,NSE,IL⁃6,and TNF⁃αare often found to be highly expressed in lung cancer patients.Additionally,tu⁃mor markers and NSE levels have been shown to be correlated with the pathological subtypes of lung cancer.These indicators can serve as valuable markers for predicting a poor prognosis in individuals with lung cancer.