CEA、CA125、CYFRA21-1、NSE和SCC对非小细胞肺癌化疗效果及进展评估的价值

Clinical value of CEA,CA125,CYFRA21-1,NSE and SCC for evaluation of chemotherapy efficacy and progression in patients with non-small-cell lung cancer

目的探讨血清肿瘤标志物癌胚抗原(CEA)、糖类癌抗原125(CA125)、细胞角蛋白-19片断抗原(CYFRA21-1)、神经元特异性烯醇化酶(NSE)及鳞状上皮细胞癌抗原(SCC)对非小细胞肺癌化疗效果及进展评估的价值。方法取Ⅰb~Ⅲa期非小细胞肺癌根治术后化疗患者35例及Ⅲb~Ⅳ期非小细胞肺癌初治化疗患者70例,将术后化疗患者分为稳定组(鳞癌13例、腺癌12例)与复发转移组(鳞癌2例、腺癌8例),Ⅲb~Ⅳ期化疗患者分为非进展组(鳞癌14例、腺癌16例)与进展组(鳞癌13例、腺癌27例)。采用化学发光法检测患者化疗前、稳定期与进展或复发转移时的血清CEA、CA125、CYFRA21-1、NSE和SCC水平,探讨其与化疗效果及疾病进展、复发、转移之间的关系。结果与化疗前相比,非小细胞肺鳞癌Ⅲb~Ⅳ期化疗患者非进展组化疗后CYFRA21-1水平明显下降(P<0.05);与化疗后稳定期比较,进展组进展时CA125、CYFRA21-1和SCC水平明显上升(P均<0.05);与化疗前相比,非小细胞肺腺癌Ⅲb~Ⅳ期患者非进展组化疗后CEA、CA125、CYFRA21-1和NSE均下降(P均<0.05);与化疗后稳定期比较,进展组进展时CEA和CA125水平升高(P均<0.05)。非小细胞肺癌Ⅰb~Ⅲa期根治术后化疗患者中,稳定组患者化疗后CA125和NSE水平较化疗前下降,而复发转移组的CEA、CYFRA21-1水平则较化疗前明显上升(P均<0.05)。结论血清肿瘤标志物CEA、CA125、CYFRA21-1、NSE和SCC可作为评估非小细胞肺癌的化疗效果及疾病进展、复发转移的敏感指标。

Objective To investigate the clinical value of serum carcinoembryonic antigen( CEA),carbohydrate antigen 125( CA125),cytokeratin fragment 19( CYFRA21-1),neuron-specific enolase( NSE) and squamous cell carcinoma antigen( SCC) for the evaluation of chemotherapy efficacy and progression in patients with non-small-cell lung cancer.Methods A total of 105 patients diagnosed with non-small-cell lung cancer were included in the study,35 of them inⅠb-Ⅲa stage received postoperative chemotherapy while 70 of them in Ⅲ b-Ⅳ stage received chemotherapy. They were grouped according to their chemotherapy effect and pathology. Patients receiving postoperative chemotherapy were divided in the stable group( 13 cases of squamous carcinoma,12 cases of adenocarcinoma) and relapse and metastasis group( 2 cases of squamous carcinoma,8 cases of adenocarcinoma),on the other hand,patients in Ⅲb-Ⅳ stage were divided into the non-progressive group( 14 cases of squamous carcinoma,16 cases of adenocarcinoma) and progressive group( 13 cases of squamous carcinoma,27 cases of adenocarcinoma). The levels of CEA,CA125,CYFRA21-1,NSE and SCC in the serum samples were detected before chemotherapy,in remission,stable state and progression of each patient. The relationships with chemotherapy efficacy,progression,recurrence and metastasis of diseases were investigated. Results During patients with non-small-cell lung cancer in Ⅲb-Ⅳ stage,the CYFRA21-1 level was significantly decreased after chemotherapy in the non-progressive group,while the levels of CA125,CYFRA21-1 and SCC were significantly increased in the progressive patients as compared with those before chemotherapy; in the patients Ⅲb-Ⅳ stage,the levels of CEA,CA125,CYFRA21-1 and NSE were significantly decreased after chemotherapy in the non-progressive group,while the levels of CEA and CA125 were significantly increased in the progressive group as compared with those before chemotherapy. During patients with non-small-cell lung cancer in Ⅰb-Ⅲa stage,the levels of CA125 and NSE were significantly decreased after chemotherapy in patients who received postoperative chemotherapy of the stable group,while the levels of CEA and CYFRA21-1were significantly increased in the relapse and metastasis group. All the differences above were statistically significant( all P < 0. 05). Conclusion CEA,CA125,CYFRA21-1,NSE and SCC could be used as the sensitive indicators for the evaluation of chemotherapy efficacy,relapse and metastasis and progression of non-small-cell lung cancer.