非小细胞肺癌患者血清多项肿瘤标志联合检测的临床意义

目的:评价癌胚抗原(CEA)、鳞状细胞癌相关抗原(SCC-Ag)、细胞角蛋白21-1片段(CYFRA21-1)、糖类抗原125(CA125)、糖类抗原153(CA153)和神经元特异性烯醇华酶(NSE)等6项标志联合检测,在非小细胞肺癌(non-small cell lung cancer,NSCLC)的临床诊断、预后及评价疗效等方面的临床意义。方法:收集284例NSCLC患者的临床资料及肿瘤标志水平,评价标志水平与病情的关系。统计学分析采用SPSS10.0软件,用Kaplan-Merier法计算生存率和无肿瘤生存率,用Log-rank法进行差异检验,对单因素分析中P<0.3的预后因素使用Cox比例风险回归进行多因素分析。结果:肿瘤标志CEA的总阳性率为42.6%,CYFRA21-1为54.2%,SCC为12.6%,CA125为51.8%,CA153为39.4%,NSE为16.5%。6项标志联合检查的总阳性率为80.3%。CEA、CA153阳性患者的化疗疗效较差,而NSE阳性患者的化疗疗效较好。出现转移或病情进展的患者中,73.1%出现阴性标志和(或)经治疗已转为阴性的标志转为阳性。全组患者的中位无病生存期为12.98(2~22)个月,中位生存期为17.69(6~22)个月。结论:CEA、SCC-Ag、CYFRA21-1、CA125、CA153和NSE等6项标志在NSCLC患者中有较高的阳性率。多项标志联合检测的阳性率远高于任一标志单独检测的阳性率。

Clinical significance of combined detection of serum levels of multiterm tumor markers in patients with non-small cell lunq cancer

OBJECTIVE:To evaluate the clinical value of combined assay of tumor markers (CEA, CYFRA21-1,SCC,CA125, CA153 and NSE) in NSCLC patients.METHODS:All the clinical informations and the serum levels of tumor markers in 284 cases of NSCLC patients were collected and detected. Kaplan-Meier was used to calculate the disease-free survival time and the overall survival time.RESULTS:The positive rates of each marker were CEA: 42.6%; CYFRA21-1: 54.2%;SCC: 12.6%;CA125: 51.8%; CA153: 39.4% and NSE: 16.5%. The positive rate of the combination of the 6 markers was 80.3%. The curative effect in the patients with positive results of CEA and CA153 was poorer than that in the patients with negative results of CEA and CA153, and the curative effect in the patients with positive result of NSE was better than that in the patients with negative result of NSE. The median of disease-free survival time of all the patients was 12.98(2-22) months and the overall survival time of all the patients was 17.69(6-22) months.CONCLUSIONS:The positive results of CEA, SCC-Ag, CYFRA21-1, CA125, CA153 and NSE are relatively high in NSCLC patients. The positive rate of combined assay of tumor markers is much higher than that of single marker.