中晚期非小细胞肺癌调强放疗联合化疗前后血清VEGF、CEA、NSE和CYFRA21-1的表达及其临床意义-现代医学

中晚期非小细胞肺癌调强放疗联合化疗前后血清VEGF、CEA、NSE和CYFRA21-1的表达及其临床意义

单位：1. 河南中医药大学第三临床医学院影像医学与核医学系, 河南郑州 450046;
2. 河南省肿瘤医院放疗科, 河南郑州 450003

分类号：R734.2

出版年·卷·期（页码）：2023·51·第四期（501-505）

摘要：

目的:探讨血清血管内皮生长因子(VEGF)、癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)和细胞角蛋白19片段(CYFRA21-1)在中晚期非小细胞肺癌调强放疗联合化疗前后的表达变化及与近期疗效的关系。方法:选取2021年7月至2022年10月河南省肿瘤医院放疗科行调强放疗联合化疗方法治疗的非小细胞肺癌的患者60例，采用酶联免疫吸附(ELISA)法检测血清VEGF，采用化学发光微粒子免疫检测法检测血清CEA、NSE和CYFRA21-1治疗前后的水平，比较不同的组织学类型和临床分期时4种肿瘤标志物的表达情况，分析治疗前后肿瘤标志物水平的变化以及肿瘤标志物水平与近期疗效的关系。结果:血清CEA在腺癌患者中表达的水平高于鳞癌(P＜0.05)，CYFRA21-1在腺癌患者中表达的水平低于鳞癌(P＜0.05)。治疗前Ⅳ期患者血清VEGF水平高于Ⅲ期患者(P＜0.05)。血清VEGF、CEA、NSE和CYFRA21-1治疗后水平均低于治疗前(P＜0.05)。治疗结束后，有效39例，无效21例，治疗有效患者的血清VEGF、CEA和 CYFRA21-1低于治疗无效的患者(P＜0.05)。结论:与肺鳞癌患者比较，肺腺癌患者血清CEA表达水平高，CYFRA21-1表达水平低，治疗前Ⅳ期患者血清VEGF水平高于Ⅲ期患者；调强放疗联合化疗后4种肿瘤标志物水平均降低，尤其是治疗后血清VEGF、CEA和CYFRA21-1的水平与近期疗效相关，可对非小细胞肺癌治疗效果有预测价值。

Objective: To investigate the expression changes of serum vascular endothelial growth factor(VEGF), carcinoembryonic antigen(CEA), neuron-specific enolase(NSE) and cytokeratin-19-fragment(CYFRA21-1) before and after intensity modulated radiotherapy combined with chemotherapy in advanced non-small cell lung cancer(NSCLC) and their relationship with short-term curative effects. Methods: 60 NSCLC patients treated with intensity-modulated radiotherapy combined with chemotherapy were selected from the radiotherapy department of Henan Cancer Hospital from July 2021 to October 2022. Enzyme-linked immunosorbent assay(ELISA) was used to detect serum VEGF levels, while chemiluminescence microparticle immunoassay was used to detect CEA, NSE, and CYFRA21-1 levels before and after treatment. The expression of the four tumor markers in different histological types and clinical stages were compared, and changes in tumor marker levels before and after treatment and their relationship with short-term curative effects were analyzed. Results: Serum CEA expression level of adenocarcinoma patients was higher than that of squamous cell carcinoma patients(P<0.05). Conversely, serum CYFRA21-1 expression level of adenocarcinoma patients was lower than that of squamous cell carcinoma patients(P<0.05). Before treatment, serum VEGF level of patients with stage Ⅳ cancer was higher than that of stage Ⅲ patients(P<0.05). After treatment, serum VEGF, CEA, NSE, and CYFRA21-1 levels were all reduced compared to pre-treatment levels(P<0.05). After finishing treatment, 39 cases were effective, while 21 cases were ineffective. Furthermore, serum VEGF, CEA, and CYFRA21-1 levels of patients with effective treatment were lower than those of patients with ineffective treatment(P<0.05). Conclusion: Compared to squamous cell carcinoma patients, the expression level of CEA is higher and expression level of CYFRA21-1 is lower in lung adenocarcinoma patients. Serum VEGF level of patients with stage Ⅳ cancer are higher than that of stage Ⅲ cancer prior to treatment. After treatment with intensity modulated radiotherapy combined with chemotherapy, the serum levels of all four tumor markers decrease, and serum VEGF, CEA, and CYFRA21-1 expression levels are correlated with short-term treatment efficacy. The levels of these markers may serve as predictors of treatment response in patients with non-small cell lung cancer.

参考文献：

[1] FERLAY J,COLOMBET M,SOERJOMATARAM I,et al.Cancer statistics for the year 2020:an overview[J].Int J Cancer,2021,149(4):1-12.
[2] YANG Z R,LIU M N,YU J H,et al.Treatment of stage Ⅲ non-small cell lung cancer in the era of immunotherapy:pathological complete response to neoadjuvant pembrolizumab and chemotherapy[J].Transl Lung Cancer Res,2020,9(5):2059-2073.
[3] FONTANINI G,VIGNATI S,BOLDRINI L,et al.Vascular endothelial growth factor is associated with neovascularization and influences progression of non-small cell lung carcinoma[J].Clin Cancer Res,1997,3(6):861-865.
[4] EISENHAUER E,THERASSE P,BOGAERTS J,et al.New response evaluation criteria in solid tumours:revised RECIST guideline(version 1.1)[J].Eur J Cancer,2009,45(2):228-247.
[5] 田含含,周锡垒,陈炜,等.调强放疗联合化疗对晚期非小细胞肺癌血清三种因子表达变化的队列研究[J].中华放射肿瘤学杂志,2021,30(10):1007-1012.
[6] 苏贺,李志刚,王一尧,等.EGFR-TKI靶向治疗对老年晚期肺癌患者肿瘤标志物及生存的影响[J].中国老年学杂志,2021,41(3):501-503.
[7] 付斌彬.血清EGFR基因突变状态、HER-2及CEA水平检测在肺癌诊断中的应用价值[J].现代医学,2018,46(10):1161-1164.
[8] WONG S,CHEUNG M T,LUK L,et al.Prognostic significance of cytokeratin 20-positive lymph node vascular endothelial growth factor A mRNA and chromodomain helicase DNA binding protein 4 in pN0 colorectal cancer patients[J].Oncotarget,2018,9(6):6737-6751.
[9] 陶绍能,王莹莹,戴云海,等.循环IGF-1、IGFBP-3和VEGF在非小细胞肺癌中的临床价值及相关性分析[J].重庆医学,2019,48(20):3460-3463.
[10] 杜炜玮,段铮,胡斌.联合血清人附睾分泌蛋白4、血管内皮细胞生长因子、白细胞分化抗原147检测在肺癌诊断及淋巴结转移监测中的价值[J].实用医院临床杂志,2022,19(3):93-96.
[11] 崔东,许广辉,贾忠伟,等.NLR、VEGF、IL-6、TNF-α水平与非小细胞肺癌预后的相关性[J].现代肿瘤医学,2019,27(14):2514-2518.
[12] GOLD P,FREEDMAN S O.Specific carcinoembryonic antigens of the human digestive system[J].J Exp Med,1965,122(3):467-481.
[13] JIANG Z F,WANG M,XU J L.Thymidine kinase 1 combined with CEA,CYFRA21-1 and NSE improved its diagnostic value for lung cancer[J].Life Sci,2018,194:1-6.
[14] 焦鑫,何思春,万绍恒,等.肿瘤标志物在肺癌诊断、预后预测中的临床价值[J].中国老年学杂志,2019,39(4):811-814.
[15] 李龙飞,渠敬明,王祥军,等.不同类型肺癌患者化疗前后血清CEA、NSE及CYFRA21-1的表达及意义[J].中国老年学杂志,2018,38(4):821-823.
[16] 陈旭蓉.血清CEA、CYFRA21-1水平与非小细胞肺癌病理类型及分期的相关性分析[J].国际检验医学杂志,2017,38(17):2488-2489.
[17] 俞峰,瞿凯泉,张利,等.不同放疗效果晚期非小细胞肺癌患者TSGF、 CA125和CEA血清水平分析[J].微循环学杂志,2020,30(3):41-43,48.
[18] 宋志雨,刘丹,张耀勇.血清癌胚抗原、糖类抗原125、血管内皮生长因子联合检测在肺癌同步放化疗疗效评估中的临床价值[J].肿瘤基础与临床,2017,30(4):316-318.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录