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目的探讨血清癌胚抗原(CEA)和细胞角蛋白19片段(CYFRA21-1)水平改变对非小细胞肺癌(NSCLC)患者术后预后的影响。方法选取2010年1月至2014年1月青海大学附属医院收治的193例NSCLC患者的病例资料进行研究。通过分析NSCLC患者术前术后血清中CEA和CYFRA21-1水平,探讨CEA和CYFRA21-1对患者术后预后的影响。结果不同TNM分期患者术后血清CEA和CYFRA21-1水平均较术前明显降低(均P<0.05),而且肿瘤分期越晚,术前术后的CEA和CYFRA21-1水平越高(P<0.05)。与术前相比,术后CEA和CYFRA21-1阳性率均显著降低(43.01%vs.59.59%,48.19%vs.65.80%,P<0.05)。随访发现,术后CEA阳性和CYFRA21-1阳性患者的生存期均明显低于正常水平[(9.33±3.48)月vs.(13.71±4.65)月,(9.67±3.96)月vs.(12.16±4.21)月,P<0.05]。Cox模型分析显示,相对CEA和CYFRA21-1正常水平,CEA阳性(HR=2.667,95%CI:1.708~4.161)和CYFRA21-1阳性(HR=1.859,95%CI:1.213~2.846)为NSCLC患者术后预后的危险因素(P<0.05)。结论外周血CEA和CYFRA21-1水平与NSCLC患者的TNM分期关系密切,其血清阳性水平可作为NSCLC患者术后预后生存期的风险预测因素。
Objective To investigate the effect of serum carcinoembryonic antigen (CEA) and cytokeratin 19 (CYFRA21-1) levels on the prognosis of patients with non-small cell lung cancer (NSCLC). Methods A total of 193 NSCLC patients admitted to Affiliated Hospital of Qinghai University from January 2010 to January 2014 were enrolled in this study. By analyzing the serum levels of CEA and CYFRA21-1 in preoperative and postoperative NSCLC patients, the effects of CEA and CYFRA21-1 on postoperative prognosis of patients were investigated. Results The serum levels of CEA and CYFRA21-1 in patients with different TNM stages were significantly lower than those before operation (all P <0.05), and the later the tumor stage, the higher CEA and CYFRA21-1 levels were (P <0.05 ). Compared with preoperative, the positive rates of CEA and CYFRA21-1 were significantly decreased (43.01% vs.59.59%, 48.19% vs.65.80%, P <0.05). Follow-up found that the survival of patients with CEA positive and CYFRA21-1 positive were significantly lower than the normal level [(9.33 ± 3.48) months vs. (13.71 ± 4.65) months, (9.67 ± 3.96) months vs (12.16 ± 4.21 ) Month, P <0.05]. Cox model analysis showed that CEA positive (HR = 2.667, 95% CI: 1.708-4.161) and CYFRA21-1 positive (HR = 1.859, 95% CI: 1.213-2.846) were significantly higher in patients with NSCLC than normal levels of CEA and CYFRA21-1 Postoperative prognostic risk factors (P <0.05). Conclusion The levels of CEA and CYFRA21-1 in peripheral blood are closely related to the TNM stage of NSCLC patients. The positive serum levels of CEA and CYFRA21-1 may be used as risk predictors for the prognosis of patients with NSCLC.