小细胞肺癌患者化疗前后CEA、NSE和CYFRA21-1变化对评估预后的作用

目的：探讨小细胞肺癌患者（SCLC）化疗前后血清CEA、NSE和CYFRA21-1变化在患者预后中的预测作用。方法：采用ELISA法检测63例病理确诊小细胞肺癌患者化疗前和两周期化疗后血清中CEA、NSE和CYFRA21-1的含量变化,化疗结束随访患者生存期。结果：全组患者平均生存时间为（21±4）月,中位生存时间为22月,1、2、3年生存率分别为76.2%、41.3%和14.3%。两周期化疗后CEA、NSE和CYFRA21-1水平降低的患者平均生存期分别为（25.7±3.5）月、（25.3±4.5）月、（24.5±5.3）月,明显较化疗后肺肿瘤标志物不降低患者平均生存期（16.0±3.9）月（P〈0.01）、（13.7±3.4）月（P〈0.01）、（16.7±3.2）月（P〈0.05）高,其1、2、3年生存率也有显著差异。结论：化疗后CEA、NSE和CYFRA21-1水平降低的患者生存期较不降低患者高,监测小细胞肺癌患者化疗前后肺肿瘤标志物的变化有助于评价患者对化疗药物敏感性及评估患者预后。

Effect of the changes of CEA,NSE and CYFRA21-1 before and after chemotherapy on the evaluation of prognosis in patients with small cell lung cancer

Objective： To investigate the significance of serum CEA,NSE and CYFRA21-1 changes in chemotherapy before and after the prognosis of small-cell lung cancer（SCLC） patients. Methods： ELISA was used to detect content changes in serum CEA, NSE and CYFRA21-1 before and after two cycles of chemotherapy in the 63 patients with pathologically confirmed SCLC. Survival time of the patients after chemotherapy were followed up. Results： The average survival time was（21 ±4）months, the median survival time was 22 months,and 1,2,3 year survival rates were 76.2%, 41.3% and 14.3% respectively. After two cycles of chemotherapy,CEA,NSE and CYFRA21-1 levels reduced in patients with an average survival time of （25.7±3.5） months,（25.3±4.5） months,（24.5±5.3）months,significantly higher than patients whose levels was not reduced with an average survival time of （16.0±3.9） months（P〈0.01）,（13.7±3.4）months（P〈0.01）,（16.7±3.2） months（P〈0.05）. Furthermore, 1, 2, 3-year survival rates were also significantly different. Conclusion： The survival time of patients with reduced CEA, NSE and CYFRA21-1 in chemotherapy are higher than the patients who are not. Monitoring changes of lung tumor markers in chemotherapy in SCLC can help to assess chemotherapy-sensitive and evaluate the prognosis of patients.