血清肿瘤标志物在晚期食管鳞状细胞癌疗效评价和预后判定中的作用

目的 探讨血清肿瘤标志物在晚期食管鳞状细胞癌(简称:鳞癌)中的表达及其在化疗疗效评价和预后判断中的意义.方法 测定50例晚期食管鳞癌患者一线化疗前后血清标志物的水平.按照实体瘤的疗效评价标准(RECIST标准)评效.通过建立受试者工作特性曲线(ROC曲线)求最佳临界值.用Kaplan-Meier法行生存分析.结果 50例患者治疗前的血清肿瘤标志物阳性率以细胞角蛋白19片段(CYFRA21-1)最高(44.0%,22/50);癌胚抗原(CEA)最低(22.0%,11/50).配对样本Wilcoxon秩和检验示部分缓解(PR)组化疗后CYFRA21-1、鳞状上皮细胞癌抗原(SCC-Ag)下降,差异有统计学意义(Z=3.181、2.389,P=0.001、0.017),进展(PD)组化疗后CYFRA21-1、SCC-Ag升高,差异有统计学意义(Z=2.701、2.250,P=0.007、0.024),稳定(SD)组化疗前后SCC-Ag、CYFRA21-1差异无统计学意义(Z=0.414、1.114,P=0.679、0.265).提示SCC-Ag、CYFRA21-1与影像学疗效评价具有一致性.ROC曲线显示化疗后CYFRA21-1较化疗前升高32%,SCC-Ag升高38%,可作为预测化疗疗效的最佳临界值,并与影像学评效具有较好的一致性.化疗后CYFRA21-1较化疗前升高＞32%和SCC-Ag较化疗前升高＞38%为晚期食管鳞癌预后不良因素.结论 CYFRA21-1和SCC-Ag对晚期食管鳞癌的诊断、预测化疗疗效和预后有重要意义.     

血清肿瘤标志物在晚期食管鳞状细胞癌疗效评价和预后判定中的作用

目的 探讨血清肿瘤标志物在晚期食管鳞状细胞癌(简称:鳞癌)中的表达及其在化疗疗效评价和预后判断中的意义.方法 测定50例晚期食管鳞癌患者一线化疗前后血清标志物的水平.按照实体瘤的疗效评价标准(RECIST标准)评效.通过建立受试者工作特性曲线(ROC曲线)求最佳临界值.用Kaplan-Meier法行生存分析.结果 50例患者治疗前的血清肿瘤标志物阳性率以细胞角蛋白19片段(CYFRA21-1)最高(44.0%,22/50);癌胚抗原(CEA)最低(22.0%,11/50).配对样本Wilcoxon秩和检验示部分缓解(PR)组化疗后CYFRA21-1、鳞状上皮细胞癌抗原(SCC-Ag)下降,差异有统计学意义(Z=3.181、2.389,P=0.001、0.017),进展(PD)组化疗后CYFRA21-1、SCC-Ag升高,差异有统计学意义(Z=2.701、2.250,P=0.007、0.024),稳定(SD)组化疗前后SCC-Ag、CYFRA21-1差异无统计学意义(Z=0.414、1.114,P=0.679、0.265).提示SCC-Ag、CYFRA21-1与影像学疗效评价具有一致性.ROC曲线显示化疗后CYFRA21-1较化疗前升高32%,SCC-Ag升高38%,可作为预测化疗疗效的最佳临界值,并与影像学评效具有较好的一致性.化疗后CYFRA21-1较化疗前升高＞32%和SCC-Ag较化疗前升高＞38%为晚期食管鳞癌预后不良因素.结论 CYFRA21-1和SCC-Ag对晚期食管鳞癌的诊断、预测化疗疗效和预后有重要意义.     

CEA、CYFRA21-1和NSE在肺癌化疗疗效评估中的价值

[目的]探讨CEA、CYFRA21-1和NSE对肺癌化疗疗效的预测价值。[方法]采用电化学发光法测定140例肺癌（腺癌62例,鳞癌46例,小细胞癌32例）患者化疗前后血清CEA、CYFRA21-1、NSE的水平,并分析其表达水平与病理类型及疗效的关系。[结果]腺癌CEA水平高于鳞癌和小细胞癌（P〈0.01）,鳞癌CYFRA21-1水平高于腺癌和小细胞癌（P〈0.01）,小细胞肺癌NSE水平高于腺癌和鳞癌（P〈0.01）。化疗有效（CR＋PR）的患者中,腺癌CEA较化疗前明显下降（t=3.126,P〈0.01）,鳞癌CYFRA21-1较化疗前明显下降（t=2.905,P〈0.01）,小细胞肺癌NSE较化疗前明显下降（t=3.216,P〈0.01）。[结论]CEA、CYFRA21-1和NSE分别在肺腺癌、鳞癌及小细胞肺癌中高表达。3种肿瘤标志物的测定有助于肺癌疗效判断和预后评估。     

血清HO-1、SCC-Ag在中晚期食管鳞癌术后化疗中的变化及临床意义

目的:探讨血清血红素加氧酶-1（HO-1）、人鳞状细胞癌相关抗原（SCC-Ag）在中晚期食管鳞癌术后化疗中的变化及临床意义。方法:选2015年9月至2017年9月行体检的174例健康人群及同期收治的116例中晚期食管鳞癌患者,分别抽取血清进行HO-1、SCC-Ag水平的监测并比较;分别于化疗前后进行上述指标的测定,并分析其HO-1、SCC-Ag水平与临床分期及病理分级之间的关系。结果:食管癌患者HO-1阳性表达率（93.97%）、SCC-Ag水平（2.49±0.63）μg/L均高于健康体检者［5.75%、（0.51±0.11）μg/L］,差异有统计学意义（P<0.05）。中、晚期食管鳞癌患者术后化疗后HO-1阳性表达率（72.55%、80.00%）、SCC-Ag水平［（1.98±0.56）μg/L、（3.76±0.97）μg/L］明显低于化疗前HO-1阳性表达率（90.20%、96.92%）和SCC-Ag水平［（2.34±0.78）μg/L、（4.08±0.98）μg/L］,差异有统计学意义（P<0.05）。晚期食管鳞癌患者HO-1阳性表达率、SCC-Ag水平高于中期食管鳞癌,差异有统计学意义（P<0.05）;肿瘤分化程度越低,HO-1阳性表达率、SCC-Ag水平越高,中、低分化食管鳞癌患者HO-1阳性表达率、SCC-Ag水平明显高于高分化食管鳞癌患者,差异有统计学意义（P<0.05）。结论:中晚期食管鳞癌患者血清HO-1、SCC-Ag水平明显高于正常人,血清HO-1、SCC-Ag在中晚期食管鳞癌术后化疗后降低,血清HO-1、SCC-Ag水平与临床分期呈正相关,血清HO-1、SCC-Ag水平可以作为中晚期食管鳞癌患者的诊断和化疗疗效观察的重要指标。     

联合检测食管鳞癌放疗前后血清SCC、VEGF、CYFRA21-1的临床意义

目的：探讨联合检测食管鳞癌患者血清鳞状上皮细胞癌相关抗原（SCC）、血管内皮生长因子（VEGF）、细胞角化素蛋白片段19（CYFRA21-1）对放疗效果评估的价值。方法：采用酶联免疫吸附法（ELISA）或电化学发光免疫分析法（ECLIA）测定80例食管鳞癌患者放疗前、后血清SCC、VEGF、CYFRA21-1水平,并以20例健康者为对照。结果：食管鳞癌组血清SCC、VEGF、CYFRA21-1水平明显高于对照组,食管鳞癌组血清SCC、VEGF、CYFRA21-1对放疗后有效者（CR＋PR）均明显低于放疗前（P〈0.05）。结论：血清SCC、VEGF、CYFRA21-1联合检测食管鳞癌放疗疗效和预后判断有较好的临床应用价值。     

A、CYFRA21-1和NSE在肺癌化疗中的临床意义

[目的]评价癌胚抗原（CEA）、细胞角蛋白19片段（CYFRA21-1）、神经元特异性烯醇化酶（NSE）3项肿瘤标志物在肺癌不同病理类型及治疗前后的表达意义。[方法]用电化学发光法分别测定246例肺癌,其中腺癌108例、鳞癌70例以及68例小细胞未分化肺癌（SCLC）患者化疗前后血清CEA、CYFRA21-1和NSE的水平。[结果]3项肿瘤标志物在肺癌不同病理类型中比较均有差异,其中腺癌CEA水平均高于其他类型（P〈0.01）,鳞癌CYFRA21-1水平高于其他类型（P〈0.01）,小细胞肺癌NSE水平高于其他类型（P〈0.01）。治疗有效的肺癌患者治疗后3项标志物水平均明显下降,而治疗无效者治疗前后均无明显变化或升高。[结论]3项肿瘤标志物水平在腺癌、鳞癌及小细胞肺癌检测中均明显升高,在治疗有效组化疗后显著下降,提示此三种指标的测定有助于肺癌预后评估和疗效判定。     

血清CEA、CYFRA21-1的变化与化疗客观疗效的相关性

背景与目的 血清肿瘤标志物浓度反映肿瘤的代谢或凋亡情况,化疗后肿瘤标志物的变化有可能反映化疗的客观疗效.研究目的在于评价化疗期间血清癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA 21-1)的变化对预测晚期NSCLC化疗疗效的价值.方法 回顾性分析42例晚期非小细胞肺癌患者化疗1周期后血清CEA、CYFRA 21-1的变化,并分析其与影像学评价的化疗客观疗效的相关性.结果 化疗2周期后,客观有效率为28.6%.化疗前,血清CEA、CYFRA 21-1水平在化疗有效组(objective response,OR)和无效组(no response,NR)间没有差别.化疗1周期后,CEA、CYFRA 21-1下降比例在OR和NR两组间有差异.用化疗后CEA、CYFRA 21-1下降比例预测化疗的客观疗效,CEA、CYFRA21-1 ROC曲线下面积分别为0.875和0.919.治疗后CEA下降比例为22%时,预测化疗客观疗效的敏感性为58.3%,特异性为97%;CYFRA 21-1下降比例为51%时,敏感性为83.3%.特异性为93.3%;以下降比例为界值,联合CEA和CYFRA21-1检测结果,可以将预测客观疗效的敏感性提高到91.7%,特异性为86.7%.结论 CEA、CYFRA 21-1化疗后下降比例可以用于评价晚期非小细胞肺癌化疗疗效,但其下降比例的界值仍需进一步研究.     

肺癌患者化疗前后外周血肿瘤标志物水平变化的临床价值

目的 对肺癌患者化疗前后外周血内肿瘤标志物水平改变进行分析.方法 随机选取50例肺癌患者,给予紫杉醇类或联合顺铂方案化疗2个周期,采用放射免疫技术对不同病理类型组化疗前后外周血内肿瘤标志物CEA、NSE、CYFRA 21-1水平进行监测,并结合化疗前后肺部CT影像学变化分析化疗前各病理类型血清肿瘤外周血内肿瘤标志物水平.结果 50例患者经2个周期化疗后,行CT影像学检测评估,肿块PR+ CR者38例,NC+ PD者12例.化疗前,腺癌组血清CEA水平显著高于鳞癌组和小细胞肺癌组;鳞癌组CYFRA 21-1水平显著高于腺癌组和小细胞肺癌;小细胞肺癌组NSE水平显著高于腺癌组和鳞癌组,数据对比差异均具有统计学意义(P＜0.05).腺癌组(CR+ PR)化疗后CEA水平显著低于化疗前;鳞癌组(CR+ PR)化疗后CYFRA 21-1水平显著低于化疗前;小细胞肺癌组(CR+ PR)化疗后NSE水平显著低于化疗前,数据对比差异均具有统计学意义(P＜0.05).结论 通过检测外周血内肿瘤标志物CEA、NSE、CYFRA 21-1水平改变可用于化疗疗效判定,具有简便、经济的特点.     

小细胞肺癌患者基于肿瘤标志物异常更换化疗方案对疗效的影响

目的 探讨小细胞肺癌治疗过程中出现肿瘤标志物升高后的治疗策略。方法 通过北京中医医院顺义医院病历资料管理系统筛选2014年2月至2019年2月之间经治的小细胞肺癌患者156例，根据肿瘤标志物升高情况及是否更换化疗方案进行分组，分为CEA组（未更换20例，更换19例）、NSE组（未更换21例，更换22例）、CYFRA21-1组（未更换18例，更换22例）和NSE+CYFRA21-1组（未更换16例，更换18例）。以各组改变治疗方案后肿瘤标志物变化情况及各组间从开始治疗到疾病进展的时间（TTP）为疗效观察指标。结果 CEA组、CYFRA21-1组更换与未更换化疗方案者相比肿瘤标志物变化差异无统计学意义（P＞0.05）；NSE组、NSE+CYFRA21-1组更换与未更换化疗方案者相比肿瘤标志物变化差异有统计学意义（P＜0.05）。CEA组、NSE组、CYFRA21-1组更换与未更换化疗方案患者的中位TTP差异无统计学意义（P＞0.05）；NSE+CYFRA21-1组更换与未更换化疗方案患者的中位TTP差异有统计学意义（P＜0.01）。结论 建议小细胞肺癌化疗患者当两项肿瘤标志物水平均异常升高时更换化疗方案，不推荐单一肿瘤标志物异常升高更换化疗方案。     

肿瘤标志物在食管鳞状细胞癌中的应用

对细胞角蛋白19片断（CYFRA21—1）、鳞状细胞癌抗原（SCC）等常规食管鳞状细胞癌（简称鳞癌）肿瘤标志物应用状况,肿瘤标志物在食管鳞癌早期诊断、预测化放疗敏感性、监测术后复发和转移、判断预后方面的研究进展作一介绍。虽然食管鳞癌肿瘤标志物的研究和报道较多,但是尚无令人满意的肿瘤标志物。蛋白质组学技术已开始用于食管鳞癌肿瘤标志物的寻找,随着分子生物学技术的进步,有望寻找到理想的肿瘤标志物,为食管鳞癌的诊断治疗提供便捷途径。     

Serum level of cytokeratin 19 fragment (CYFRA 21-1) indicates tumour stage and prognosis of squamous cell carcinoma of the oesophagus

To determine the clinical efficacy of serum concentration of cytokeratin 19 fragment (CYFRA 21-1), sera from 66 patients with oesophageal squamous cell carcinoma were examined, and 54 surgically resected specimens were immunohistochemically stained for cytokeratin 19 (CK-19). The patients with positive CK-19 staining in the tissues of their carcinomas had significantly higher serum CYFRA 21-1 levels compared with those with negative CK-19 staining. When the cut-off value was defined as 2.0 ng/mL, CYFRA 21-1 had a higher positive ratio than that of either squamous cell carcinoma antigen (SCC-Ag) or carcinoembryonic antigen (CEA). Serum CYFRA 21-1 level increased significantly along with the clinical stages. In addition, serum CYFRA 21-1 level served as a prognostic factor for patients with oesophageal carcinoma after surgery, whilst SSC-Ag and CEA is not connected with the outcome. These findings suggest that the serum CYFRA 21-1 probably originated from the tumour tissue is an important marker for determining the stage and outcome of oesophageal carcinoma.     

Decline in serum carcinoembryonic antigen and cytokeratin 19 fragment during chemotherapy predicts objective response and survival in patients with advanced nonsmall cell lung cancer

BACKGROUND: The authors assessed the predictive and prognostic role of decline in the serum levels of carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (CYFRA 21-1) during chemotherapy in patients with advanced nonsmall cell lung cancer (NSCLC). METHODS: Changes in serum levels of CEA and CYFRA 21-1 during first-line, conventional chemotherapy were studied prospectively with an immunometric assay at baseline and every 2 courses in 117 patients with advanced NSCLC. Data were correlated with radiologic objective response (OR) and survival. RESULTS: One hundred seven patients were evaluable for radiologic and serologic response assessment after 2 chemotherapy courses. The radiologic OR rate was 44% overall. The CEA and CYFRA 21-1 responses (> or =20% reduction over baseline level; assessed after the second course of chemotherapy) were 38% and 61%, respectively. Statistically significant correlations were observed between CEA and CYFRA 21-1 responses and OR (P = .01 and P = .004, respectively). The median survival from response assessment (landmark analysis) was 9 months. In a univariate analysis, disease stage, performance status, baseline lactate dehydrogenase level (LDH), OR, CEA response, and CYFRA 21-1 response were correlated significantly with survival. In particular, the median survival was 13 months for patients who had a CEA response and 11 months for patients who had a CYFRA 21-1 response compared with 8 months and 6 months for patients who did not respond, respectively. In a multivariate analysis, performance status (P = .005), baseline LDH level (P = .02), CEA response (P = .03) and CYFRA 21-1 response (P = .01) were confirmed as independent prognostic factors for survival. CONCLUSIONS: CEA and CYFRA 21-1 responses appeared to be reliable surrogate markers of chemotherapy efficacy in patients with advanced NSCLC.     

Prognostic significance of CYFRA21-1, CEA and hemoglobin in patients with esophageal squamous cancer undergoing concurrent chemoradiotherapy

Purpose: To evaluate the prognostic value of serum CYFRA21-1, CEA and hemoglobin levels regardinglong-term survival of patients with esophageal squamous cell carcinoma (ESCC) treated with concurrentchemoradiotherapy (CRT). Methods: Age, gender, Karnofsky Performance Status (KPS), tumor location,tumor length, T stage, N stage and serum hemoglobin, and CYFRA21-1 and CEA levels before concurrent CRTwere retrospectively investigated and related to outcome in 113 patients receiving 5-fluorouracil and cisplatincombined with radiotherapy for ESCC. The Kaplan-Meier method was used to analyze prognosis, the log-rankto compare groups, the Cox proportional hazards model for multivariate analysis, and ROC curve analysis forassessment of predictive performance of biologic markers. Results: The median survival time was 20.1 monthsand the 1-, 2-, 3-, 5- year overall survival rates were 66.4%, 43.4%, 31.9% and 15.0%, respectively. Univariateanalysis showed that factors associated with prognosis were KPS, tumor length, T-stage, N-stage, hemoglobin,CYFRA21-1 and CEA level. Multivariate analysis showed T-stage, N-stage, hemoglobin, CYFRA21-1 and CEAlevel were independent predictors of prognosis. By ROC curve, CYFRA21-1 and hemoglobin showed betterpredictive performance for OS than CEA (AUC= 0.791, 0.704, 0.545; P=0.000, 0.000, 0.409). Conclusions: Ofall clinicopathological and molecular factors, T stage, N stage, hemoglobin, CYFRA21-1 and CEA level wereindependent predictors of prognosis for patients with ESCC treated with concurrent CRT. Among biomarkers,CYFRA21-1 and hemoglobin may have a better predictive potential than CEA for long-term outcomes.     

常用血清肿瘤标志物在可手术肺癌患者预后中的价值

目的 探讨血清CEA、CA125、CA199、NSE、CYFRA21-1和SCC-Ag水平在评估非小细胞肺癌根治手术后的预后价值,以期合理选择术前的检验指标。方法 收集1 851例行肺癌根治手术的患者术前血清肿瘤标志物的检验值、临床病理和随访信息,进行差异及生存分析。结果 CEA、CA125、CA199、CYFRA21-1和SCC-Ag的阳性率在不同病理分期中差异有统计学意义（P<0.001）,Ⅱ和Ⅲ期的患者阳性率明显高于Ⅰ期患者,而NSE差异无统计学意义（P=0.743）。CEA、CA125、CA199、CYFRA21-1阴性组患者的生存率显著高于阳性组（P<0.05）。NSE阴性的患者远期生存率劣于阳性组患者（P=0.033）。SCC-Ag阳性与阴性患者的远期生存率差异无统计学意义（P=0.072）。Cox回归比例风险模型分析发现CEA（HR=1.572, 95%CI: 1.117~2.214, P=0.010）、CA125（HR=2.464, 95%CI:1.610~3.772, P<0.001）和CYFRA21-1（HR=1.445, 95%CI: 1.044~2.000, P=0.027）是评价非小细胞肺癌手术预后的独立危险因素。结论 CEA、CA125和CYFRA21-1在评价非小细胞肺癌手术预后方面有良好的应用价值,而CA199、NSE和SCC-Ag等指标价值有限。     

血清细胞角蛋白19片段与晚期非小细胞肺癌患者化疗疗效及预后关系的研究

目的:探讨晚期非小细胞肺癌(NSCLC)患者化疗前后血清细胞角蛋白19片段(CYFRA21-1)变化水平与影像学疗效哪个因素与预后的关系最密切。方法:采用电化学发光免疫法检测112例晚期NSCLC患者化疗前后血清CYFRA21-1水平变化,并将其变化水平与临床反应类型进行比较。结果:经过2个周期化疗后,112例患者中有80例可行影像学和血清学疗效评价,其中,影像学客观缓解率为26.3%,疾病控制率为65.0%。80例患者的中位生存期(MST)为9.9个月。影像学缓解(OR)与疾病控制(DC)患者的MST相似(P=0.094),但均长于PD患者(P均<0.001)。化疗后血清CYFRA21-1水平下降幅度与临床疗效相符。血清CYFRA21-1水平下降幅度≥30%和≥60%对于诊断DC和OR有最佳灵敏度和特异度。血清CY-FRA21-1水平下降幅度≥30%与DC(P<0.001)及生存期(P<0.001)密切相关。多因素分析表明,DC(RR=0.450,P=0.017)及血清CYFRA21-1水平下降幅度≥30%(RR=0.429,P=0.002)是影响预后的独立因素,而OR与生存期无关。结论:DC较OR更适合作为判定NSCLC化疗疗效的指标,血清CYFRA21-1水平下降幅度≥30%有望成为评价NSCLC化疗疗效的替代指标。     

5种肿瘤标志物联合检测在口腔鳞状细胞癌中的诊断价值

目的:通过检测血清肿瘤标志物（SCC-Ag、CYFRA21-1、CEA、CA125、NSE）探讨联合检测对口腔鳞状细胞癌(oral squamous cell carcinoma，OSCC)的临床诊断意义及诊断效能。方法:收集2015年1月至2018年1月就诊于新疆维吾尔自治区人民医院口腔颌面外科的OSCC患者60例，非OSCC恶性肿瘤患者60例，同期健康体检者60例作为正常组，均抽取空腹外周血2 ml，检测SCC-Ag、CYFRA21-1、CEA、CA125、NSE浓度。结果:OSCC患者的5种血清肿瘤标志物水平与非OSCC恶性肿瘤组、正常组比较差异具有统计学意义(P<0.05)。将CEA、CA125、SCC-Ag、CYFRA21-1、NSE联合检测后敏感性、特异性、准确性、阳性预测值均显著提高。结论:SCC-Ag、CYFRA21-1、CEA、CA125、NSE 5种肿瘤标志物在OSCC中联合检测可以显著提高诊断效能；5种肿瘤标志物的血清表达量在OSCC的临床诊断中具有一定的价值。     

肺鳞癌CEA及CYFRA 21—1和NSE检测的临床意义

目的 研究癌胚抗原(CEA)、细胞角质蛋白(CYFRA21-1)和神经元特异性烯醇化酶(NSE)在肺鳞状细胞癌(SQC)患者血清中的水平与患者TNM分期、可否行手术治疗及预后之间的关系.方法 检测210例SQC患者的血清标本(Ⅰ期20例、Ⅱ期27例、ⅢA期55例、ⅢB期80例、Ⅳ期28例)CEA、CYFRA 21-1和NSE的血清水平.NSE和CYFRA21-1采用放免测定,CEA采用化学发光法测定.结果 CYFRA 21-1升高最为常见.CEA和CYFRA 21-1与TNM分期相关,而NSE与TNM分期无关.CEA和CYFRA 21-1血清水平均值与可手术(1、Ⅱ、ⅢA)和不可手术(ⅢB、Ⅳ期)有相关性(P<0.001).NSE血清水平均值与可否手术差异无显著性.结论 治疗前CYFRA 21-1和NSE的血清浓度与预后有关,可作为SQC患者可否手术的参考指标,并可为SQC预后判断提供重要信息.     

Serum Sialyl Lewis x and cytokeratin 19 fragment as predictive factors for recurrence in patients with stage I non-small cell lung cancer

This study aimed to establish the clinical significance of preoperative serum cytokeratin 19 fragment (CYFRA21-1) and Sialyl Lewis(x) (SLX) in patients with stage I non-small cell lung cancer (NSCLC). The study involved 137 patients (87 male, 50 female; median age 69 years) with completely resected stage I NSCLC. SLX, carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC), and CYFRA21-1 were examined. Receiver operator characteristic (ROC) curves were constructed to determine prognostic cut-off values. Among the 137 patients, we identified 30 with recurrence within 3 years. The 5-year survival rates in patients with (n=30) and without (n=107) recurrence were 14% and 81%, respectively. The serum concentrations of SLX, CEA, and CYFRA21-1 in the recurrence group were significantly higher than those in the non-recurrence group. The areas under the ROC curve (AUC) were 0.72, 0.65, 0.53, and 0.64 for SLX, CEA, SCC, and CYFRA21-1, respectively. The prognostic cut-off values were 36U/ml, 7.8ng/ml, 1.5ng/ml, and 3.2ng/ml for SLX, CEA, SCC, and CYFRA21-1, respectively. A log-rank test revealed that age, performance status, T factor, lymphatic invasion, vascular invasion, SLX, CEA, SCC, and CYFRA21-1 were all significantly associated with survival. By multivariate analysis, age, performance status, lymphatic invasion, SLX (risk ratio, 4.11) and CYFRA21-1 (risk ratio, 3.47) were independent prognostic factors. For patients positive for both CYFRA21-1 and SLX, the relative risk was 5.32 compared with patients who were negative for both markers. The 5-year survival rates were 80% in the group negative for both markers (n=86); 52% in the group positive for one of the markers (n=43); and 13% for the group positive for both markers (n=8) (p<0.001). We concluded that serum SLX and CYFRA21-1 were prognostic markers for stage I NSCLC. Their combination should contribute to the classification of stage I NSCLC patients. There is a need to consider adjuvant and neoadjuvant therapies to improve prognosis in patients positive for both tumor markers.