血清肿瘤标志物对晚期原发性肺癌老年患者放疗疗效的评估价值

目的：探讨血清肿瘤标志物对晚期原发性肺癌老年患者放疗疗效的评估价值。方法纳入156例晚期原发性肺癌老年患者，放疗结束6周后比较患者的近期疗效并将患者分为完全缓解（complete response， CR）+部分缓解（partial response，PR）组（即CR+PR组）、疾病稳定（stable disease，SD）组（即SD组）及疾病进展（progressive disease，PD）组（即PD组），比较不同组患者治疗前后血清中癌胚抗原（carcinoembryonic antigen， CEA）、细胞角蛋白21-1片段（human cytokeratin fragment antigen 21-1，CYFRA21-1）、鳞状细胞癌抗原（squa-mous cell carcinoma，SCC）及癌抗原125（carbohydrate antigen 125，CA125）的水平，并计算以血清肿瘤标志物水平评估放疗疗效的方法的灵敏度和特异度。结果156例患者放疗后，CR有2例（1.28%），PR有83例（53.21%），SD有22例（14.10%），以及PD有49例（31.41%）。放疗后CR+PR组患者的CEA、CYFRA21-1、SCC及CA125水平均显著低于治疗前水平（P＜0.05），SD组患者治疗后各血清肿瘤标志物水平与治疗前无明显差异（P＞0.05），PD组患者治疗后各血清肿瘤标志物水平均显著高于放疗前水平（P＜0.05）。以血清肿瘤标志物水平评估放疗疗效的方法的灵敏度为72.94%，特异度为76.06%。结论血清肿瘤标志物CEA、CYFRA21-1、SCC及CA125可较准确地评估晚期原发性肺癌老年患者的放疗疗效，并具有较高的灵敏度与准确度。

Evaluation value of serum tumor markers for the efficacy of radiotherapy for advanced primary lung cancer in elderly patients

Objective To discuss the evaluation value of serum tumor markers for the efficacy of radiotherapy for advanced primary lung cancer in elderly patients. Method A total of 156 elderly patients with advanced primary lung cancer underwent radiotherapy. The short-term effects were measured and compared at 6th week after radiothera-py and the patients were divided as CR+PR group, SD group, and PD group. The levels of CEA (carcinoembryonic antigen), CYFRA21-1 (human cytokeratin fragment antigen 21-1), SCC (squamous cell carcinoma) and CA125 (carbo-hydrate antigen 125) in serum were measured and compared before and after radiotherapy for different groups, and the sensitivity and specificity of the method evaluating the efficacy of radiotherapy by serum tumor markers were cal-culated. Result In the 156 patients, there were 2 (1.28%) patients of CR, 83 (53.21%) of PR, 22 (14.10%) of SD and 49 (31.41%) of PD. The levels of CEA, CYFRA21-1, SCC and CA125 in CR+PR group decreased after radio-therapy (P<0.05), while those in the SD group had no significant difference before and after radiotherapy (P>0.05), and those in the PD group increased after radiotherapy (P<0.05). The sensitivity of the method was 72.94%, and the specificity was 76.06%. Conclusion The serum tumor markers of CEA, CYFRA21-1, SCC and CA125 can be used in assessing short-term efficacy after radiotherapy in elderly patients with advanced primary lung cancer, and the method is of satisfactory sensitivity and specificity.