CAJ | 학술논문

目的研究鼻咽未分化癌患者放疗前后血清人细胞角蛋白21-1片段(CFRA21-1)和癌胚抗原(CEA)水平与预后的关系.方法回顾性分析2004年5月至2008年2月月随访资料完整、并经病理学确诊为无远处转移的62例鼻咽未分化癌患者的临床资料.所有患者均采用6MV X线调强放疗,分析放疗前后CYFBA21-1及CEA水平与患者预后的关系.结果放疗前CYFRA21-1高水平组(>2.49μg/L)患者的总生存率明显低于放疗前低水平组(≤2.49μg/L),差异有统计学意义χ2=5.643,P=0.018).N分期和T分期与患者无瘤生存时间有关(OR=4.054,P=0.001;OR=3.873,P=0.001).在多因素分析中,无因素对复发及远处转移有明显的预测作用.CEA水平与患者预后无明显的相关性.结论放疗前血清CYFRA21-1水平与鼻咽未分化癌患者的预后密切相关,放疗前CYFRA21-1高水平患者的预后较差.
목적 연구비인미분화암환자방료전후혈청인세포각단백21-1편단(CFRA21-1)화암배항원(CEA)수평여예후적관계.방법 회고성분석2004년5월지2008년2월월수방자료완정、병경병이학학진위무원처전이적62례비인미분화암환자적림상자료.소유환자균채용6MV X선조강방료,분석방료전후CYFBA21-1급CEA수평여환자예후적관계.결과 방료전CYFRA21-1고수평조(>2.49μg/L)환자적총생존솔명현저우방료전저수평조(≤2.49μg/L),차이유통계학의의χ2=5.643,P=0.018).N분기화T분기여환자무류생존시간유관(OR=4.054,P=0.001;OR=3.873,P=0.001).재다인소분석중,무인소대복발급원처전이유명현적예측작용.CEA수평여환자예후무명현적상관성.결론 방료전혈청CYFRA21-1수평여비인미분화암환자적예후밀절상관,방료전CYFRA21-1고수평환자적예후교차.
Objective The purpose of this study was to evaluate the potential of CYFRA 21-1 (CYFRA) and CEA as a prognostic marker in patients with undifferentiated nasopharyngeal carcinoma ( NPC). Methods From March 2004 to February 2008, 62 patients with newly diagnosed, undifferentiated NPC were treated in our department. Their clinocopathological data were analyzed retrospectively. All patients received intensity-modulated radiotherapy using 6 MV X-rays, and serum CYFRA and CEA before and after radiotherapy were assayed. The association among the long-term follow-up results and age, sex, smoke, TNM stage, chemotherapy, CEA, CYFRA and the changes in any direction of serum CYFRA and CEA were determined. Results Patients with low pre-RT level ( ≤ 2. 49μg/L) of CYFRA had a significantly better overall survival ( OS) than patients with high level ( > 2. 49 μg/L,OR = 8. 555, P = 0.029). N classification and T classification were positively associated with the prediction of progression free survival ( OR = 4. 054, P = 0. 001; OR = 3. 873, P = 0. 001 ). But there was no significant association between the rest predictors (age, sex, CEA, post-RT CYFRA, chemotherapy and a radiation-induced decrease in serum markers) and the survival or recurrence rate by multivariate analysis. Conclusions The results of the present study show that pre-RT serum CYFRA level is a valuable factor for predicting long-term survival in patients with undifferentiated nasopharyngeal carcinoma. More aggressive treatment may be given to those patients with a high serum CYFRA level.