化疗前后肺癌肿瘤标记物水平的变化及其临床价值

目的探讨肺癌患者化疗前后肿瘤标记物水平变化对肺癌化疗效果评价的价值。方法新疆医科大学附属肿瘤医院228例临床确诊的肺癌患者，均经过2个周期的化疗，监测鳞癌、腺癌及小细胞肺癌3组不同类型肺癌化疗前及化疗后肿瘤标记物癌胚抗原（CEA）、神经元特异性烯醇化（NSE）、细胞角质蛋白19片段（CYFRA21－1）水平的变化，结合其化疗前后肺部CT影像学改变进行分析并评价疗效。结果CYFRA21—1、CEA、NSE分别在鳞癌、腺癌及小细胞肺癌中的检测水平明显高于其他类型肺癌（P〈0．05），经过2个周期化疗后CYFRA21—1、CEA、NSE测定值的变化在鳞癌、腺癌及小细胞肺癌中的差异有统计学意义，鳞癌患者CYFRA21—1测定值在基本缓解（PR）患者中明显降低，稳定（SD）和进展（PD）患者中无明显变化，腺癌患者cEA测定值在PR患者中明显降低，PD患者中明显升高；小细胞肺癌患者NSE测定值在PR患者中明显降低，SD和PD患者中无明显变化。结论肺癌患者血清CEA、NSE、CYFRA21—1测定有助于肿瘤细胞类型的判断，化疗前、后血清水平的变化与治疗效果密切相关。

Changes of levels of Tumor markers in patients with lung cancer before and after chemotherapy and its clinical significance

Objective To discuss the value of lung cancer tumor marker levels change before and after chemotherapy. Methods 228 patients with clinically diagnosed patients with lung cancer were analyzed, all passed two cycles of chemotherapy, and observed the tumor markers changes of CEA, NSE and CY- FRA21-1 before three different types of chemotherapy, and combine with the changes of Chest CT, and evaluate the curative effect. Results The positive rate of CEA, NSE, CYFRA21-1 is significantly higher respectively in lung adenocarcinoma, small cell lung cancer （SCLC）, squamous carcinoma group than other types of lung cancer （P 〈0.05）. After two weeksr chemotheraphy, CEA was significantly higher with adenocarcinoma than other subtypes of lung cancer （P 〈0.05）; The level of NSE was significantly higher in patients with SCLC than other subtypes of lung cancer （P 〈0.05） ; The level of CYFRA21-1 was significantly higher in patients with squamous carcinoma than other subtypes of lung cancer （P 〈0.05）; The level of CEA was dropped significantly after chemotherapy in PR patients with adenocarcinoma and in creased obviously in PD patients with adenocarcinoma; The level of NSE was dropped significantly before chemotherapy in PR patients with SCLC; The level of CYFRA21-1 was dropped significantly before chemotherapy in PR patients with squamous carcinoma. Conclusion The serum determination of CEA, NSE, and CYFRA21-1 were conducive to judge the types of tumor cell. The serum change after chemotherapy was closely correlated with the therapeutic effect.