细胞角蛋白19-2G2和细胞角蛋白19片段抗原在非小细胞肺癌化疗疗效评估中的价值

摘要

目的 评价血清肿瘤标志物细胞角蛋白19-2G2(CK-2G2)和细胞角蛋白19片段抗原(Cyfra21-1)在非小细胞肺癌(NSCLC)疗效评估中的临床应用价值.方法 应用化学发光法检测124例NSCLC(腺癌74例,鳞癌50例)患者化疗前、化疗1个周期和2个周期血清中CK-2G2和Cyfra21-1的水平.经正态性检验,CK-2G2和Cyfra21-1水平为偏态分布资料,以M(QR)表示,组间和化疗前后比较采用秩和检验.结果 腺癌和鳞癌患者化疗1个周期后CK-2G2和Cyfra21-1的水平明显下降[腺癌患者分别为0.77(0.03 ～ 55.85)U/L比1.86(0.02 ～ 55.60)U/L、1.88(0.15 ～ 18.65)μg/L比2.35(0.14 ～22.32)μg/L;鳞癌患者分别为1.67(0.04～218.60)U/L比4.75(0.05 ～ 226.30)U/L、2.12(0.12 ～ 20.65)μg/L比4.07(0.11～40.21)μg/L].疾病进展患者(9例)化疗1个周期后CK-2G2和Cyfra21-1的水平明显升高(P＜0.01)；疾病稳定患者(49例)和部分缓解患者(66例)化疗1个周期后CK-2G2的水平明显下降(P＜0.01)；化疗2个周期后与化疗1个周期后比较,NSCLC患者CK-2G2和Cyfa21-1的水平无明显变化(P＞0.05).结论 肿瘤标志物CK-2G2和Cyfra21-1可作为NSCLC化疗早期疗效评价参考指标.%Objective To investigate the clinical significance of cytokeratin 19-2G2(CK-2G2)and Cyfra21-1 for assessment of efficacy of chemotherapy in patients with non-small-cell lung cancer. Methods The serum levels of CK-2G2 and Cyfra21-1 were detected by Chemiluminescence(CLIA)in 124 patients with non-small-cell lung cancer before chemotherapy,after treatment for one period and after treatment for two periods.Results The levels of CK-2G2 and Cyfra21-1 in patients with adenocarcinoma after treatment for one period were significantly lower than those of patients before chemotherapy[0.77(0.03-55.85)U/L vs 1.86(0.02-55.60)U/L,1.88(0.15-18.65)μg/L vs 2.35(0.14-22.32)μg/L](P ＜ 0.05).The levels of CK-2G2 and Cyfra21-1 in patients with squamous-cell carcinoma after treatment for one period were significantly lower than those of patients before chemotherapy [1.67(0.04-218.60)U/L vs 4.75(0.05-226.30)U/L,2.12(0.12-20.65)μg/L vs 4.07(0. 11-40.21)μg/L](P ＜ 0.01).The levels of CK-2G2 and Cyfra21-1 in patients with progressive disease after treatment for one period were significantly higher than those of patients before chemotherapy(P ＜ 0.01).The levels of CK2G2 and Cyfra21-1 in patients with stable disease and partial remission after treatment for one period were significantly lower than those of patients before chemotherapy(P ＜ 0.01).There were no significant changes of the levels of CK-2G2 and Cyfra21-1 in patients after treatment for two periods compared with patients after treatment for one period(P ＞ 0.05).Conclusion The tumor markers CK-2G2 and Cyfra21-1 are valuable to monitor patients with non-small-cell lung cancer.