非小细胞肺癌血清VEGF与CA125 CEA Cyfra21-1 的相关性及临床意义*

目的：探讨化疗前血清血管内皮生长因子（VEGF）检测在非小细胞肺癌（NSCLC ）中的临床应用价值，同时测定血清中CA125、CEA 、Cyfra21-1 的滴度及其相关性。方法：采用抗人VEGF单克隆抗体、夹心ELISA 法测定78例NSCLC 患者血清VEGF浓度。同时利用放射免疫法检测血清中CEA 、CA125、Cyfra21-1 的浓度。结果：NSCLC 有远处转移组血清VEGF、CA125、CEA 浓度显著高于无远处转移组（P<0.05）；有淋巴结转移组血清VEGF显著高于无淋巴结转移组（P<0.05）。 血清VEGF和CA125、CEA 在Ⅲ+ Ⅳ期NSCLC 的表达显著高于I+II 期NSCLC（P<0.05）。 血清CEA 在腺癌中显著增高（P<0.05）。 血清VEGF、CA125 阴性组的化疗有效率（35.3% 、35.7%）显著高于阳性组（7.7% 、15.8%）（P=0.004，0.006）。 化疗前血清CEA 阴性者的中位总生存时间（mOS ）较阳性者明显延长（分别为36个月，20个月；P=0.04）；而血清VEGF、Cyfra21-1、CA125 浓度对mOS 无明显影响（P 值分别为0.07，0.099，0.19）。 血清CEA 、VEGF、Cyfra21-1、CA125 表达对中位无瘤生存期（mTTP）均无明显影响（P 值分别为0.119，0.280，0.146，0.230）。 NSCLC 患者血清VEGF 与CEA 表达存在显著正相关（P<0.05），其他肿瘤标志物之间无显著相关性（P>0.05）。 结论：综合检测NSCLC 患者化疗前血清肿瘤标志物可能有利于协助诊断、预测转移、评价化疗疗效及判断预后。

Relationship between Serum VEGF,CA125,CEA,and CYFRA21-1 Levels in Non-small Cell Lung Cancer Patients and the Clinical Significance

Objective: To investigate the clinical value of detecting serum VEGF, CEA, CA125 , and Cy-fra21-1 in non-small cell lung cancer (NSCLC) patients, and to explore the relationship between these levels and prognosis. Methods:In 78NSCLC patients, the serum VEGF levels were detected by ELISA, and the se-rum levels of CEA, CA 125 , and Cyfra21-1 were detected by radioimmunoassay before chemotherapy.Results: Serum levels of VEGF, CA125 and CEA were significantly higher in NSCLC patients with lymph node metastasis or other distant metastasis than in those without lymph node metastasis or other distant metasta-sis ( P<0.05). Serum levels of VEGF, CEA and CA125 were significantly higher in stage Ⅰand ⅡNSCLC pa -tients than in stage Ⅲand ⅣNSCLC patients ( P<0.05). Serum CEA levels were higher in patients with ade -nocarcinoma than in patients with other malignancies ( P<0.05). The chemotherapy response rate of NSCLC patients without VEGF or CEA expression was higher than that of those with VEGF (35.3% vs. 7.7% ,P= 0.004 ) or CEA ( 35.7% vs. 15.8% ,P=0.006 ) expression. The mean overall survival of CEA negative NSCLC patients was longer than those with CEA expression ( 36m vs. 20m,P=0.04). Serum levels of VEGF (P=0.07), Cyfra 21-1 (P=0.099 ), and CA 125 (P=0.19) were not correlated with overall survival. Serum levels of CEA (P=0.119 ), VEGF ( P=0.280 ), Cyfra 21-1 (P=0.146 ) and CA125 (P=0.230 ) were not correlated with mean time to progression of NSCLC. A positive correlation was observed between serum VEGF level and serum CEA level. No correlation was found among serum levels of CA125 , Cyfra21-1 and VEGF. Conclusion:The dectection of serum tumor markers in NSCLC patients before chemotherapy may be helpful for diagnosis, prediction of metastasis, chemotherapy response rate, and judgment of prognosis.