非小细胞肺癌患者化疗前后血清CYFRA211、CEA、NSE、CA125、CA199水平的变化及临床意义

摘要

Obj ective To investigate the changes of cytokeratin 1 9 fragment (CYFRA211),carcinoembryonic antigen (CEA),sugar decomposition enolase (NSE),carbohy-drate antigen 125 (CA125),carbohydrate antigen 199 (CA199)in non-small cell lung cancer pa-tients before and after chemotherapy and explore its clinical significance.Methods A total of 60 pa-tients with advanced non-small cell lung cancer were treated with 2 cycles (3 weeks per cycle)of cis-platin plus gemcitabine chemotherapy (GP).Serum CYFRA211,CEA,NSE,CA125,CA199 in patients were detected before and after chemotherapy.Results Positive rates of CYFRA211, serumCEA ,NSE ,CA 1 2 5 and CA 1 9 9 before chemotherapy in all patients were 6 1 .6 7%,5 1 .6 7%, 71.67%,53.33%,31.67%.Positive rates of serum CEA,CA125 adenocarcinoma were signifi-cantly higher than patients with squamous cell carcinomas (P<0.05 or P<0.01 ).The positive rate of NSE staging for stage IV patients was significantly higher than that in stageⅢpatients (P<0.05).After chemotherapy,5 cases had complete response,14 cases had partial response,25 cases had stable disease (SD),16 cases had progressive disease (PD).Among them,the indexes of patients with CR,PR were significantly lower than those before treatment (P<0 .05 ),SD patients with serum NSE,CA125 levels were significantly lower (P<0.05),PD patients serum CYFRA211, CEA,CA125 levels significantly increased than before treatment (P<0.05 ).Conclusion Serum CYFRA211,CEA,NSE,CA125,CA199 level can reflect Chemotherapy curative effect for patients with advanced non-small cell lung cancer.The short-term effect,tumor stage,and serum CYFRA211 levels before chemotherapy are the independent factors of prognosis.%目的：观察非小细胞肺癌患者化疗前后血清细胞角蛋白19片段（CYFRA211）、癌胚抗原（CEA）、糖分解烯醇酶（NSE）、糖类抗原125（CA125）、糖类抗原199（CA199）水平变化，并探讨其临床意义。方法60例晚期非小细胞肺癌患者均接受2个周期的顺铂＋吉西他滨（GP）方案化疗，3周为一个疗程。化疗前后均检测患者血清CYFRA211、CEA、NSE、CA125、CA199水平。结果所有患者化疗前血清CYFRA211、CEA、NSE、CA125、CA199阳性率分别为61．67％、51．67％、71．67％、53．33％、31．67％。腺癌患者血清CEA、CA125的阳性率显著高于鳞癌患者（P＜0．01或P＜0．05）；肿瘤分期为Ⅳ期患者的NSE阳性率显著高于Ⅲ期患者（P＜0．05）。化疗后完全缓解（CR）5例、部分缓解（PR）14例、稳定（SD）25例、疾病进展（PD）16例；其中，CR、PR患者各指标均较化疗前显著降低（P＜0．05），SD患者血清NSE、CA125水平显著降低（P＜0．05），PD患者血清CYFRA211、CEA、CA125水平较化疗前显著升高（P＜0．05）。COX模型多因素分析表明，患者预后与近期疗效、肿瘤分期、化疗前血清CYFRA211水平密切相关（P＜0．05）。结论血清CYFRA211、CEA、NSE、CA125、CA199水平可评价晚期非小细胞肺癌患者的化疗疗效；近期疗效、肿瘤分期及化疗前血清CYFRA211水平是影响患者预后的独立因素。