摘要
目的探究肺腺癌患者可能的预后以及其影响因素,并对CEA、CYFRA21-1、NSE在肺腺癌中的诊断效能及阳性诊断值进行临床回顾性分析评价。方法分别对208例肺腺癌和肺部良性病变205例患者的临床资料,包括患者年龄、性别、吸烟、分化程度、淋巴结转移、肿瘤大小、TNM分期、术前血清CEA、CYFRA21-1、NSE水平、术后病理诊断、生存情况,进行回顾性分析并随访;使用统计学的软件为SPSS22.0,采取χ^2检验对计数资料进行组间评比分析;采用Kaplan-Meie计算患者的生存率,以及Log-rank法进行组间比较,并通过COX回归分析患者生存时间受各临床病理特征及相关因素的影响;采取ROC曲线评比各指标预测肺腺癌的能力。结果单因素cox回归分析显示肿瘤大小(χ^2=9.341,P=0.025)、TNM分期(χ^2=20.071,P=0.003)、淋巴结是否转移(χ^2=13.309,P=0.000)、CEA(χ^2=16.381,P=0.000)为总体生存率的影响因素,多因素cox回归分析表明总体生存期的独立影响因素是CEA和淋巴结转移;CEA、CYFRA21-1对于预测肺腺癌具有较高的预测价值(P<0.001),对应的最佳截断值分别为3.33μg/mL(灵敏度53.8%,特异度84.4%)、1.95 ng/mL(灵敏度79.3%,特异度43.4%),而NSE不具有预测价值(P=0.182)。结论肺腺癌患者CEA和淋巴结转移是预测估计其未来过程和结局的关键影响要素;对于肺腺癌具有较高预测价值的血清肿瘤标标记物是CEA、CYFRA21-1,它们在LUAD的诊断和高危人群的筛查有重要价值。
Objective A retrospective analysis was carried out to further explore the prognosis of patients with lung adenocarcinoma(ADC)and the relevant influencing factors and to analyze the diagnostic efficiency and positive diagnostic values of carcinoembryonic antigen(CEA),CYFRA 21-1 and neuron-specific enolase(NSE)in lung ADC.Methods The clinical data of 208 patients with lung ADC and 205 patients with benign pulmonary lesions,including age,sex,smoking history,differentiation,lymphatic metastasis,tumor size,tumor,node and metastasis(TNM)stages,preoperative serum CEA,CYFRA21-1,NSE,postoperative pathologic diagnosis and survival,were retrospectively analyzed and all the patients were followed up.SPSS 22.0 software was adopted for statistical analysis,chi-square test to compare enumeration data between groups,Kaplan-Meier to calculate the survival rate of patients and Log-rank method for comparison between groups.Moreover,COX regression analysis was used to assess the influence of different clinical pathological characteristics and relevant factors on survival of patients and ROC curve to evaluate the ability of these indexes for predicating lung ADC.Results Univariate COX regression analysis revealed that tumor size(χ^2=9.341,P=0.025),TNM stages(χ^2=20.071,P=0.003),lymphatic metastasis or not(χ^2=13.309,P=0.000)and CEA(χ^2=16.381,P=0.000)were influencing factors of overall survival.Multivariate COX regression analysis suggested that the independent influencing factors of overall survival were CEA and lymphatic metastasis.CEA and CYFRA21-1 were of high predicative value for lung ADC(P<0.001),whose optimal cut-off values were 3.33 g/mL(sensitivity 53.8%and specificity 84.4%),1.95 ng/mL(sensitivity 79.3%and specificity 43.4%),while NSE had no predicative value(P=0.182).Conclusion CEA and lymphatic metastasis are critical factors for predicating prognosis and outcomes of patients with lung ADC while CEA and CYFRA21-1 are serum tumor markers of high predicative value for these patients,which play an important role in the
作者
吴琪燕
边革元
程绘珺
李娇霞
王书廷
黄照略
WU Qi-yan;BIAN Ge-yuan;CHENG Hui-jun;LI Jiao-xia;WANG Shu-ting;HUANG Zhao-lve(Dept.of Nuclear Medicine,Yan'an Hospital Affiliated to Kunming Medical University,Kunming Yunnan 650051;The Intensive Care Unit of Emergency Department,the 920th Hospital of Joint Logistic Support Force of Chinese PLA,Kunming Yunnan 650032;Dept.of Thoracic Surgery,the 3rd Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650118,China)
出处
《昆明医科大学学报》
CAS
2020年第9期32-37,共6页
Journal of Kunming Medical University
基金
云南省教育厅科学研究基金资助项目(2017zzx197)
云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目[2017FE467(-083),2018FE001(-247)]。
关键词
肺腺癌
预后分析
血清肿瘤标志物
诊断
Lung ADC
Prognosis analysis
Serum tumor markers
Diagnosis
