肺癌患者血清癌胚抗原和Ki-67对预测预后的作用

目的探讨血清癌胚抗原(carcino-embryonic antigen, CEA)、Ki-67对不同病理类型肺癌患者无进展生存期(progression-free survival, PFS)的预测作用。方法 100例肺癌患者,均行血清CEA和Ki-67水平检测,根据中位CEA水平分为CEA高表达(CEA>4.215μg/L)者51例和CEA低表达(CEA≤4.215μg/L)者49例,根据Ki-67表达情况分为Ki-67阳性表达(Ki-67≥75%)者37例和Ki-67阴性表达(Ki-67<75%)者63例,分析CEA高表达、Ki-67阳性患者临床和病理指标的关系,并采用Kaplan-Meier法进行生存分析,比较CEA高表达者与低表达者及Ki-67阳性与阴性者PFS。结果 CEA高表达和Ki-67阳性患者在病理类型上差异有统计学意义(P<0.05),肺腺癌患者CEA高表达发生率最高,小细胞肺癌Ki-67阳性发生率最高,CEA高表达及Ki-67阳性患者在年龄、性别比例、有吸烟史比率、分化程度、淋巴结转移比率、TNM分期上差异无统计学意义(P>0.05);CEA高表达患者PFS(22.5个月)与CEA低表达患者(20.9个月)比较差异无统计学意义(P>0.05),Ki-67阳性患者PFS(20.1个月)低于Ki-67阴性患者(22.8个月)(P<0.05)。结论 CEA对肺癌患者的PFS无预测作用,Ki-67对肺癌患者PFS有预测作用,Ki-67阳性患者生存期短。

Role of serum carcino-embryonic antigen and Ki-67 in predicting prognosis of lung cancer patients

Objective To investigate the roles of serum carcino-embryonic antigen(CEA) and Ki-67 in predicting progression-free survival(PFS) in patients with different pathological types of lung cancer. Methods Totally 100 patients were divided into high-CEA expression group(n=51, CEA>4.215 μg/L) and low-CEA expression group(n=49, CEA≤4.215 μg/L) according to the median CEA level, and Ki-67 positive expression group(n=37, Ki-67≥75%) and Ki-67 negative expression group(n=63, Ki-67<75%) according to the expression level of Ki-67. The correlations of high-CEA expression rate and Ki-67 positive rate with clinical and pathological indexes were analyzed, and Kaplan-Meier method was used for the survival analysis to compare the PFS between high-and low-CEA expression groups, as well as between Ki-67 positive and negative expression groups. Results There were significant differences in the high-CEA expression rate and Ki-67 positive rate in patients with different pathological types(P<0.05), and no significant differences in age, sex ratio, percentage of smoking history, differentiation degree, lymph node metastasis ratio and TNM stages(P>0.05). There were no significant differences in PFS between high-and low-CEA expression groups(22.5 months vs. 20.9 months). The PFS was shorter in Ki-67 positive expression group(20.1 months) than that in Ki-67 negative expression group(22.8 months)(P<0.05). Conclusion Ki-67 but not CEA can predict PFS in lung cancer patients, and PFS is shorter in Ki-67 positive patients.