神经元特异性烯醇化酶、癌胚抗原、乳酸脱氢酶在小细胞肺癌中的预后价值比较

目的　评价神经元特异性烯醇化酶(NSE)、癌胚抗原(CEA)、乳酸脱氢酶(LDH)在小细胞肺癌(SCLC)患者中的预后价值。方法　收集苏州大学附属第二医院1997年12月至2 0 0 3年11月确诊的4 6例非手术治疗的SCLC患者,在治疗前检测NSE、CEA、LDH及其它实验室指标,进行预后单因素和多因素分析。结果　NSE、CEA、LDH的升高率分别为4 8.3%、4 2 .9%、30 .4 % ,三者水平在广泛期均高于局限期,其中LDH、CEA有显著统计学意义(P <0 .0 5 )。单因素分析NSE >12ng/ml,、LDH >1(与上限比值)均是提示预后较差的指标。多因素分析时,NSE是独立的预后因子,LDH、CEA的影响不明显。结论　NSE、CEA、LDH中,NSE与预后的相关性最强,是提示预后的独立指标。

Comparative Prognostic Value of Neuron-specific Enolase、Carcinoembryonic Antigen and Lactate Dehydrogenase in Small-cell Lung Cancer Patients

Objective To evaluate the prognostic significance of neuron-specific enolase(NSE)carcinoembryonic antigen(CEA)lactate dehydrogenase(LDH) in small-cell lung cancer(SCLC). Methods A total of 46 histologically proven and unresectable SCLC patients were included. NSECEALDH and other laboratory variables were tested before therapy. Results LDH was elevated in 30.4% of the patients,CEA in 42.9%,NSE in 48.3%.Among them LDH and CEA were significantly higher when the disease was considered extensive than when it was limited.The univariate analysis showed that patients whose NSE is greater than 12 ng/ml,LDH is greater than 1(ratio of this value to the upper limit) had a significant shorter survival in comparison with the opposite status of each variables.The multivariate survival analysis showed that NSE was a more important prognostic factor than LDH and CEA. Conclusion NSE is an independent prognostic factor for small-cell lung cancer.