CYFRA21-1、CA125、NSE在脑膜癌脑脊液中的表达及其临床预测价值分析

Expression of CYFRA21-1,CA125 and NSE in Cerebrospinal Fluid of Meningeal Carcinoma and Its Clinical Predictive Value Analysis

目的分析细胞角蛋白19片段(CYFRA21-1)、糖类抗原125(CA125)、神经元特异性烯醇化酶(NSE)在脑膜癌脑脊液中的表达水平及其临床预测价值。方法选取脑膜癌124例作为研究组,另选取同期124例结核性脑膜炎作为对照组;采用酶联免疫吸附(ELISA)法检测脑脊液CYFRA21-1、CA125、NSE水平;采用Pearson法分析脑脊液CYFRA21-1、CA125、NSE的相关性;采用COX回归分析脑膜癌患者预后的影响因素;通过受试者工作特征(ROC)曲线来分析脑脊液CYFRA21-1、CA125、NSE水平对脑膜癌患者预后的预测价值。结果研究组脑脊液CYFRA21-1、CA125、NSE水平均显著高于对照组(P<0.05)。根据pearson相关性分析得知,脑脊液CYFRA21-1与CA125,CYFRA21-1与NSE,CA125与NSE水平均呈正相关(γ=0.524,0.531,0.516,P<0.05)。脑脊液CYFRA21-1、CA125、NSE水平与KPS评分有关(P<0.05)。预后死亡组脑脊液CYFRA21-1、CA125、NSE水平显著高于预后生存组(P<0.05)。根据COX回归分析表明,CYFRA21-1、CA125、NSE高表达是影响脑膜癌患者预后的危险因素(P<0.05)。根据ROC曲线得知,脑脊液CYFRA21-1预测脑膜癌患者预后的曲线下面积(AUC)为0.814,CA125预测脑膜癌患者预后的AUC为0.853,NSE预测脑膜癌患者预后的AUC为0.849,三者联合预测脑膜癌患者预后的AUC为0.959,三者联合优于CYFRA21-1、CA125、NSE各自单独预测(Z_(联合vs CYFRA21-1)=3.632、Z_(联合vs CA125)=2.852、Z_(联合vs NSE)=2.889,P均<0.05)。结论CYFRA21-1、CA125、NSE在脑膜癌患者脑脊液中的表达水平显著升高,并与患者预后密切相关,三者联合可提高脑膜癌患者预后的预测价值。

Objective To analyse the expression levels of cytokeratin 19 fragment(CYFRA21-1),glycan antigen 125(CA125),and neuron-specific enolase(NSE)in the cerebrospinal fluid of meningeal carcinomas and their clinical predictive value.Methods 124 cases of meningeal carcinoma were selected as the study group and another 124 cases of tuberculous meningitis were selected as the control group;enzyme linked immunosorbent assay(ELISA)was applied to detect the levels of CYFRA21-1,CA125,and NSE in cerebrospinal fluid;Pearson's method was applied to analyze the correlation between cerebrospinal fluid CYFRA21-1,CA125,and NSE;COX regression was applied to analyze the prognostic factors of meningeal cancer patients;ROC curve was applied to analyze the predictive value of cerebrospinal fluid CYFRA21-1,CA125,and NSE levels for the prognosis of meningeal cancer patients.Results The levels of CYFRA21-1,CA125,and NSE in the cerebrospinal fluid in the study group were obviously higher than those in the control group(P<0.05).According to Pearson correlation analysis,there was a positive correlation between CYFRA21-1 and CA125,CYFRA21-1 and NSE,and CA125 and NSE levels in cerebrospinal fluid(γ=0.524,0.531,0.516,P<0.05).The levels of CYFRA21-1,CA125,and NSE in cerebrospinal fluid were correlated with KPS score(P<0.05).The cerebrospinal fluid levels of CYFRA21-1,CA125,and NSE in the prognosis death group were obviously higher than those in the prognosis survival group(P<0.05).According to COX regression analysis,high expression levels of CYFRA21-1,CA125,and NSE were risk factors affecting the prognosis of meningeal cancer patients(P<0.05).According to the ROC curve,the area under the curve(AUC)of cerebrospinal fluid CYFRA21-1 for predicting the prognosis of meningeal cancer patients was 0.814,that of CA125 for predicting the prognosis of meningeal cancer patients was 0.853,and that of NSE for predicting the prog-[LM]nosis of meningeal cancer patients was 0.849,the AUC of the combined prediction for the prognosis of meningeal cancer patients was 0.959,which was better than CYFRA21-1,CA125,and NSE alone(Z_(combination vs CYFRA21-1)=3.632,Z_(combinationvsCA125)=2.852,Z_(combination vs NSE)=2.889,all P<0.05).Conclusion The expression levels of CYFRA21-1,CA125,and NSE in cerebrospinal fluid of meningeal cancer patients are obviously increased,the three factors are closely related to the prognosis of patients,and their combination can improve the predictive value for prognosis in meningeal cancer patients.