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目的 :研究CYFRA2 1 1作为血清肿瘤标记物对Ⅲ期非小细胞肺癌患者预后判断的临床应用价值。方法 :分别于放疗前和放疗结束时采集 46例初治的Ⅲ期非小细胞肺癌患者血清样本共 92份 ,用放射免疫法检测其CYFRA2 1 1含量。临床随访 6～ 2 4月。结果 :46例初治的Ⅲ期非小细胞肺癌患者血清CYFRA2 1 1总阳性率 5 8 70 %,鳞癌 71 43 %、腺癌 3 8 89%。放疗结束时血清CYFRA2 1 1含量较放疗前显著下降 (Wilcoxon检验 ,P <0 0 0 0 1)。存活分析表明 :Ⅲ期非小细胞肺癌患者治疗前血清CYFRA2 1 1初始水平与预后无相关性 (Mantel′slog rank检验 ,P >0 0 5 ) ;放疗结束时血清CYFRA2 1 1正常组 (≤ 3 3ng/ml) 2年生存率明显高于CYFRA2 1 1升高组 ( >3 3ng/ml) (P <0 0 5 ) ;放疗结束时血清CYFRA2 1 1含量较放疗前下降≥ 5 0 %的病人 ,其 2年生存率显著高于放疗结束时血清CYFRA2 1 1含量较放疗前下降 <5 0 %的病人(P <0 0 1)。结论 :Ⅲ期非小细胞肺癌患者放疗结束时的血清CYFRA2 1 1水平是一个有意义的阴性预后指标 ,尤其是放疗后血清CYFRA2 1 1含量下降程度的大小对临床判断预后有非常重要的价值。
Objective: To study the clinical value of CYFRA211 as a serum tumor marker for the prognosis of patients with stage III non-small cell lung cancer. Methods: A total of 92 serum samples of 46 patients with stage III NSCLC were collected before radiotherapy and at the end of radiotherapy. CYFRA2 11 levels were detected by radioimmunoassay. Clinical follow-up 6 to 2 April. Results: The total positive rate of serum CYFRA2 11 in 46 patients with stage III non-small cell lung cancer was 58.7%, squamous cell carcinoma was 71.43%, adenocarcinoma was 38.89%. Serum CYFRA2 1 1 levels at the end of radiotherapy were significantly lower than before radiotherapy (Wilcoxon test, P <0 0 0 0 1). Survival analysis showed that there was no correlation between the initial level of serum CYFRA211 before treatment and the prognosis in patients with stage III non-small cell lung cancer (Mantel’s log rank test, P > 0 05); at the end of radiotherapy, serum CYFRA2 1 1 normal group (≤ 3 The 2-year survival rate of 3ng/ml was significantly higher than that of the CYFRA2 1 1 elevated group (>3 3ng/ml) (P <0 05); the serum CYFRA211-1 level at the end of radiotherapy was ≥ 50% lower than before radiotherapy. The 2-year survival rate was significantly higher than that of the patients whose serum CYFRA2 1 1 level decreased by less than 50% compared with that before radiotherapy at the end of radiotherapy (P < 0 01). Conclusion: The serum CYFRA211 level at the end of radiotherapy in patients with stage III NSCLC is a significant negative prognostic indicator, especially the degree of decrease in serum CYFRA211 level after radiotherapy is of great value for clinical judgment of prognosis.