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目的探讨术前血清肿瘤标记物细胞角蛋白片段19(Cytokeratin 19,即CYFRA21-1)及糖类抗原15-3(CA15-3)对Ⅰ期非小细胞肺癌(NSCLC)预后评估的意义。方法回顾性研究500例病理类型为Ⅰ期的非小细胞肺癌患者,用放射免疫分析法测定其术前血清CYFRA21-1和CA15-3的水平,并进行相关的预后评估分析。结果Ⅰ期非小细胞肺癌的患者术前血清CYFRA21-1水平正常组与升高组5年生存率分别为82.6%和70.8%,差别有明显统计学意义(P=0.003);术前血清CA15-3水平正常组(85.6%)的5年生存率高于升高组(35.9%)(P<0.0001)。在单因素分析中,术前血清CYFRA21-1水平(P=0.003)、CA15-3水平(P<0.0001)、年龄(P<0.0001)、性别(P=0.001)及病理类型(P=0.001)均与预后有明显相关性。而多因素分析结果显示,年龄(95%CI为1.398~3.105,P<0.0001)、CYFRA21-1水平(95%CI为1.203~1.621,P=0.006)及CA15-3水平(95%CI为3.667~9.304,P<0.0001)是判断预后的最重要因素。结论术前血清年龄、CYFRA21-1和CA15-3水平是判断Ⅰ期NSCLC预后不良的重要指标,与患者预后有明显的相关性。
Objective To investigate the significance of preoperative serum tumor markers cytokeratin 19 (CYFRA21-1) and carbohydrate antigen 15-3 (CA15-3) in the prognosis evaluation of stage Ⅰ non-small cell lung cancer (NSCLC). Methods A retrospective study of 500 patients with stage Ⅰ non-small cell lung cancer was performed. Radioimmunoassay was used to determine the serum levels of preoperative serum CYFRA21-1 and CA15-3 and to evaluate the prognosis. Results The preoperative serum CYFRA21-1 level in patients with stage I non-small cell lung cancer was 82.6% and 70.8%, respectively, with a significant difference (P = 0.003). Preoperative serum CA15 The 5-year survival rate of the -3 normal group (85.6%) was higher than that of the elevated group (35.9%) (P <0.0001). In univariate analysis, preoperative serum levels of CYFRA21-1 (P = 0.003), CA15-3 (P <0.0001), age (P <0.0001), gender (P = 0.001) and pathological type Have a clear correlation with the prognosis. The multivariate analysis showed that age (95% CI: 1.398-3.105, P <0.0001), CYFRA21-1 level (95% CI 1.203-1.621, P = 0.006) and CA15-3 level (95% CI 3.667 ~ 9.304, P <0.0001) is the most important factor to judge the prognosis. Conclusions Preoperative serum age, CYFRA21-1 and CA15-3 levels are important indexes for judging the poor prognosis of stage Ⅰ NSCLC and have a clear correlation with the prognosis of patients.