非小细胞肺癌脑转移患者血清肿瘤标志与临床病理、近期疗效及预后的相关性分析

目的 探讨非小细胞肺癌(NSCLC)脑转移患者血清肿瘤标志与临床病理、近期疗效及预后的相关性.方法 选取2004年5月—2012年1月收治的128例NSCLC患者作为研究对象,采用回顾性分析法分析所有患者的临床资料.记录NSCLC患者脑转移发生情况,并观察分析所有患者的一般临床及病理资料、相关血清肿瘤标志物水平、近期疗效和预后情况.研究NSCLC脑转移患者相关血清肿瘤标志物与临床病理、近期疗效和预后的相关性,并通过Cox回归模型研究影响患者预后的相关危险因素.结果 发生脑转移NSCLC患者的癌胚抗原(CEA)水平和腺癌所占比例均明显高于未发生脑转移NSCLC患者(P<0.05).临床治疗有效患者的CEA水平较治疗前明显降低,而治疗进展者则较治疗前明显升高(P<0.05).腺癌患者的CEA水平明显高于鳞癌和其他患者(P<0.05).NSCLC脑转移患者随着肿瘤分期的增加CEA水平也逐渐上升(P<0.05).多因素Cox回归模型分析显示,健康状态评分、脑转移病灶数目、CEA水平以及放疗均为影响NSCLC脑转移患者预后的独立危险因素(P<0.05).结论 CEA与NSCLC脑转移患者的病理特征和近期疗效存在一定的相关性,且为影响NSCLC脑转移患者预后的独立危险因素.

Correlations Analysis between Serum Tumor Marker with Clinical Pathology,Short-term Effect and Prognosis of NSCLC Patients with Brain Metastases

Objective To investigate correlations between serum tumor marker with clinical pathology, short term effect and prognosis of non-small-cell lung carcinoma ( NSCLC) patients with brain metastases. Methods Clinical data of 128 NSCLC patients admitted during May 2004 and January 2012 was retrospectively analyzed. Conditions of brain metastasis in NSCLC patients were recorded, and generally clinical and pathological data, serum levels of tumor markers, short-term effect and prognosis were observed and analyzed. Correlations between serum tumor markers with clinical pa-thology, short-term effect and prognosis in NSCLC patients with brain metastasis were studied, and related risk factors af-fecting prognosis were analyzed by Cox regression model. Results Values of carcinoembryonic antigen ( CEA) level and having adenocarcinoma proportion in NSCLC patients with brain metastasis were significantly higher than those in NSCLC patients without brain metastasis (P<0. 05). CEA levels were significantly lower than those before treatment in patients with effective treatment, while the levels treatment were significantly higher than those before treatment in patients with developed conditions (P<0. 05). CEA levels in patients with adenocarcinoma were significantly higher than those in pa-tients with squamous cell carcinoma and other diseases (P<0. 05). CEA levels were increased gradually with increasing tumor staging in NSCLC patients with brain metastasis ( P <0. 05 ) . Multivariate Cox regression analysis showed that health status score, number of brain metastatic lesions, CEA levels and radiotherapy were independent risk factors of af-fecting prognoses of NSCLC patients with brain metastasis (P<0. 05). Conclusion CEA has a certain correlations with pathological features and short-term effect of NSCLC patients with brain metastasis, and it is an independent risk factor of affecting prognosis.