CYFRA21-1化疗前后变化早期评估进展期非小细胞肺癌化疗疗效的价值

摘要

Objective To explore early predictive evaluation of radiological diease control (DC) and prognosis of CYFRA21 - 1 change pre - and post - chemotherapy of one cycle in patients with advanced non - small - cell lung cancer( NSCLC) , which may help to early determine whether treatment protocols of the patients need to be modified. Methods The serum CYFRA21 - 1 levels in 46 patients with NSCLC of pre - and post - chemotherapy of one cycle were detected. Efficacy of CYFRA21 - 1 change in predictive evaluation of diease control( DC) was evaluated using receiver operating characteristic curve( ROC) . The correlation of CYFRA21 - 1 change and prognosis was explored,too. Results When the change rates of the CYFRA21 - 1 levels were used to predict DC of patients, the area of ROC curve was 0. 796. And when the cut - point of the change rates of CYFRA21 - 1 levels was - 16. 6% , the sensitivity and specificity were respectively 91.9% and 77. 8% . Logistic multiunivariate regression analysis confirmed that CYFRA21 - 1 change was an independent prediction factor in predictive evaluation of DC(P＜0.01). Univariate survival analysis showed that the progression -free survival(PFS) of positive patients in CYFRA21 - 1 change was much longer than that of negative patients( media PFS 5. 84 months and 1.21 months respectively, P＜0.01). COX multivariate survival analysis showed that CYFRA21 - 1 change wasn't an independent prognosis factor of prediction of PFS(P＞0.05) , but DC, loss of weight and chemotherapy cycles were all independent prognosis factors in NSCLC patients(P ＜0.05). Conclusion CYFRA21 - 1 change can predict evaluation of radiological DC and PFS in advanced NSCLC patients with increased CYFRA21 - 1 levels. It provides important message about modification of treatment protocols and is worth to be further explored.%目的 本研究通过检测进展期非小细胞肺癌( non - small cell lung cancer,NSCLC)患者1个周期化疗前后CYFRA21 -1水平变化来评价其在早期预评价影像学疾病控制(diease control,DC)和预后中的效能和价值,为早期确定是否需要调整治疗方案提供依据.方法 检测46例NSCLC患者化疗前、1个周期化疗后血液中CYFRA21-1水平；应用受试者特种工作曲线来评价CYFRA21 -1变化对化疗后影像学DC的预评价效能；探讨CYFRA21 -1变化和预后的关系.结果 CYFRA21 -1变化率预评价患者DC的ROC曲线下面积为0.796,当CYFRA21 -1变化率为- 16.6％时,敏感度和特异度分别为91.9％和77.8％.Logistitc多因素风险回归分析知CYFRA21-1变化是预评价DC的独立预评价因子(P＜0.01).单因素生存分析知CYFRA21 -1变化阳性的患者肿瘤无疾病进展时间( progression - free survival,PFS)明显长于阴性患者(中位值分别为5.84个月和1.21个月,P＜0.01).COX多因素风险回归模型进一步分析知CYFRA21-1变化(P＞0.05)不是预测PFS的独立预后因子.结论 在CYFRA21 -1水平升高的进展期NSCLC患者中,1个周期化疗前后CYFRA21 -1变化可以预评价影像学DC和预测PFS,这为早期确定是否调整治疗方案提供了依据,值的进一步研究.