晚期肺癌患者血清CEA、CYFRA21-1、SCC、NSE水平变化的临床意义

摘要

目的 探讨癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)、鳞状细胞癌相关抗原(SCC)和神经烯醇化酶(NSE)在晚期肺癌患者化疗疗效评估中的价值.方法 选择136例晚期肺癌患者(肺癌组)和40例肺部良性疾病患者(对照组),对肺癌组进行至少2个疗程的化疗,比较化疗前肺癌组和对照组、肺癌组不同病理类型患者血清CEA、CYFRA21-1、SCC和NSE水平,并比较肺癌组不同疗效患者化疗前后上述肿瘤标志物水平的变化情况.结果 化疗前肺癌组血清CEA、NSE、CYFRA21-1、SCC水平均高于对照组(P<0.01);鳞癌患者血清CEA水平高于腺癌患者和小细胞癌患者(P<0.01),小细胞癌患者血清NSE水平高于腺癌患者和鳞癌患者(P<0.01),鳞癌患者血清CYFRA21-1、SCC水平均高于腺癌患者和小细胞患者(P<0.01).腺癌部分缓解(PR)患者化疗后血清CEA水平显著下降(P<0.01),鳞癌PR患者化疗后血清CYFRA21-1、SCC水平显著下降(P<0.05),小细胞癌PR患者化疗后血清NSE水平显著降低(P<0.01),各组化疗后稳定的和有进展的患者化疗前后血清CEA、NSE、CYFRA21-1、SCC水平差异均无统计学意义(P>0.05).结论 CEA、CYFRA21-1、SCC、NSE可作为肺腺癌、肺鳞癌和小细胞癌化疗有效的评估指标,但对化疗无效患者检测意义不大.%Objective To evaluate the value of carcino embryonic antigen(CEA),carbohydrate antigen 19,cytokeratin(CYFRA21-1),squamous cell cancer antigen(SCC) and neuron specific enolase(NSE) for the evaluation of chemotherapy response in the patients with advanced lung cancer.Methods One hundred and thirty-six patients with advanced lung cancer(lung cancer group) and 40 patients with lung benign disease(control group) were collected.The lung cancer group was treated with at least two courses of chemotherapy.The CYFRA21-1,SCC,CEA and NSE levels before chemotherapy were compared among the lung cancer group,control group and the patients with different pathological types.The above mentioned tumor markers levels before and after chemotherapy were compared among the patients with different curative effects in the lung cancer group.Results The levels of serum NSE,CYFRA21-1,CEA and SCC before treatment in the lung cancer group were higher than those in the control group(P<0.01);the serum CEA level of the squamous carcinoma group was higher than that of the adenocarcinoma group and the small cell carcinoma group(P<0.01),and the serum NSE level of the small cell carcinoma group was higher than that of the adenocarcinoma and squamous cell carcinoma group(P<0.01),and the levels of CYFRA21-1 and SCC of the squamouscarcinoma group were higher than those of the adenocarcinoma and small cell groups(P<0.01).The serum CEA level of patial remission(PR) patients in adenocarcinoma group was significantly decreased(P<0.01),the serum SCC level of PR patients in the squamous cell carcinoma group was significantly decreased(P<0.05),and the serum NSE level of PR patients in small cell carcinoma group was significantly decreased after chemotherapy(P<0.01).The difference of serum NSE,CYFRA21-1 and SCC after chemotherapy in stnble and prosgoressive patients of various groups were not statistically significant(P>0.05).Conclusion CEA,CYFRA21-1,SCC and NSE can be used as the effective evaluation indexes of chemotherapy in lung adenocarcinoma,lung squamous cell carcinoma and small cell carcinoma,but which has little significance in the patients without effect of chemotherapy.