CAJ | 학술논문

目的：研究非小细胞肺癌( NSCLC)患者血清中细胞质胸苷激酶(TK1)、癌胚抗原(CEA)、鳞状细胞癌抗原(SCC-Ag)、细胞角蛋白19片段(CYFRA21-1)手术前后的表达水平变化及意义。方法选择行手术治疗的 NSCLC患者55例作为肺癌组及同期普胸外科良性疾病患者29例作为对照组,用电化学发光法检测NSCLC患者手术前后及对照组血清中TK1、CEA、SCC-Ag、CYFRA21-1水平。分析两组血清4种肿瘤标志物( TM)水平变化。结果① NSCLC患者手术前血清TK1、CEA、SCC-Ag、CYFRA21-1水平及阳性率高于对照组水平( P<0．05)。②肺癌组 NSCLC患者血清 TK1术前、术后1周、术后1个月血清TK1水平变化呈先上升后下降趋势,差异无统计学意义( P>0．05)；肺癌组NSCLC患者手术后1周及术后1个月血清CEA、SCC-Ag、CYFRA21-1水平明显低于术前水平(P<0．05)；肺癌组NSCLC患者手术后1周、术后1个月血清CEA、CYFRA21-1水平与对照组相比,差异均无统计学意义( P>0．05),其中术后1周血清TK1、SCC-Ag水平与对照组相比差异有统计学意义( P<0．05),术后1个月血清TK1、SCC-Ag水平与对照组相比差异无统计学意义(P>0．05)。③肺腺癌术前血清TK1、CEA水平高于肺鳞癌( P <0．05)。④ NSCLC 患者术前血清 TK1、CY-FRA21-1水平在女性患者中高于男性患者,差异有统计学意义(P<0．05),肺癌组NSCLC患者术前血清CEA、SCC-Ag水平与性别无显著相关性( P>0．05)。 NSCLC患者术前血清TK1水平与肺癌分化程度呈负相关( P <0．05)。结论NSCLC围手术期相关TM水平的监测对NSCLC的诊断、鉴别诊断提供帮助,有助于从微观角度了解机体肿瘤负荷变化情况。 NSCLC 围手术期相关TM水平变化与手术疗效、组织类型存在一定相关性,TM TK1和CEA 更适合于肺腺癌的评估,值得临床进一步推广应用。
목적：연구비소세포폐암( NSCLC)환자혈청중세포질흉감격매(TK1)、암배항원(CEA)、린상세포암항원(SCC-Ag)、세포각단백19편단(CYFRA21-1)수술전후적표체수평변화급의의。방법선택행수술치료적 NSCLC환자55례작위폐암조급동기보흉외과량성질병환자29례작위대조조,용전화학발광법검측NSCLC환자수술전후급대조조혈청중TK1、CEA、SCC-Ag、CYFRA21-1수평。분석량조혈청4충종류표지물( TM)수평변화。결과① NSCLC환자수술전혈청TK1、CEA、SCC-Ag、CYFRA21-1수평급양성솔고우대조조수평( P<0．05)。②폐암조 NSCLC환자혈청 TK1술전、술후1주、술후1개월혈청TK1수평변화정선상승후하강추세,차이무통계학의의( P>0．05)；폐암조NSCLC환자수술후1주급술후1개월혈청CEA、SCC-Ag、CYFRA21-1수평명현저우술전수평(P<0．05)；폐암조NSCLC환자수술후1주、술후1개월혈청CEA、CYFRA21-1수평여대조조상비,차이균무통계학의의( P>0．05),기중술후1주혈청TK1、SCC-Ag수평여대조조상비차이유통계학의의( P<0．05),술후1개월혈청TK1、SCC-Ag수평여대조조상비차이무통계학의의(P>0．05)。③폐선암술전혈청TK1、CEA수평고우폐린암( P <0．05)。④ NSCLC 환자술전혈청 TK1、CY-FRA21-1수평재녀성환자중고우남성환자,차이유통계학의의(P<0．05),폐암조NSCLC환자술전혈청CEA、SCC-Ag수평여성별무현저상관성( P>0．05)。 NSCLC환자술전혈청TK1수평여폐암분화정도정부상관( P <0．05)。결론NSCLC위수술기상관TM수평적감측대NSCLC적진단、감별진단제공방조,유조우종미관각도료해궤체종류부하변화정황。 NSCLC 위수술기상관TM수평변화여수술료효、조직류형존재일정상관성,TM TK1화CEA 경괄합우폐선암적평고,치득림상진일보추엄응용。
Objective To investigate the change and effect of operation on TK1,CEA, SCC-Ag and CYFRA21-1 level in non-small cell lung cancer patients. Methods From January 2013 to August 2013, 55 patients with NSCLC and 29 patients with benign lesions were recruited. The tumor indexes including TK1,CEA, SCC-Ag and CYFRA21-1 were measured by electrical chemiluminescence assay. Results ① Serum TK1, CEA, SCC-Ag and CYFRA21-1 level and the positive rates in NSCLC patients during preoperative period were higher than the benign disease control group ( P<0. 05 ) . ② Serum TK1 level changes in NSCLC patients preoperative and postoperative one week and one month showed a trend of hump-shaped curve, there was no obvious statistically significant differ-ence ( P>0. 05 ) . Serum CEA , SCC-Ag and CYFRA21-1 level of postoperative one week and one month in NSCLC patients were significantly lower than the level before the operation ( P<0. 05 ) . Serum CEA and CYFRA21-1 level of postoperative one week and one month in NSCLC patients showed no significant difference compared with benign disease control group ( P>0. 05 ) , serum TK1 and SCC-Ag level of the postoperative one week showed statistically significant difference compared with benign disease control group ( P<0. 05 ) , the postoperative one month level of serum TK1 and SCC-Ag showed no significant difference compared with benign disease control group ( P>0. 05 ) .③The preoperative level of TK1 and CEA in adenocarcinoma were higher than that in squamous carcinoma ( P<0. 05 ) . ④ The preoperative level of serum TK1 and CYFRA21-1 in female NSCLC patients were higher than male patients, the difference was statistically significant ( P <0. 05 ) , preoperative serum CEA and SCC-Ag level of NSCLC patients showed no obvious statistical correlation with gender ( P>0. 05 ) . The preoperative level of serum TK1 in NSCLC patients negatively correlated with the degree of differentiation of lung cancer, the difference was statistically significant ( P<0. 05 ) . Conclusion The perioperative level of tumor markers in NSCLC may be useful in monitoring diagnosis and differential diagnosis of NSCLC, especially in analyzing the invisible tumor burden of NSCLC patients. The perioperative level of tumor markers in NSCLC is related with the surgical effect and tissue types, and serum TK1 and CEA are more suitable for the evaluation of patients with lung adenocarcinoma. There is some value in the clinical applications.