CAJ | 학술논문

目的研究血清CYfra21-1在治疗Ⅲ、Ⅳ期肺鳞状细胞癌过程中的动态变化及与预后的关系.方法选择生存期均<3年且治疗进程中均出现血清CYfra21-1的动态变化的肺鳞状细胞癌患者,其中ⅢA期组34例,ⅢB~Ⅳ期组32例.对ⅢA期及ⅢB~Ⅳ期患者的起始血清CYfra21-1水平、最低血清水平、开始增高时间、开始增高至死亡时间、倍增时间及年龄进行比较.对是否手术及上述指标进行单因素预后分析,对单因素预后分析有意义的指标纳入COX比例风险回归进行多因素预后分析.结果最低血清CYfra21-1在ⅢA期组(1.97±1.79ng/ml)中显著低于ⅢB~Ⅳ期组(4.78±2.88ng/ml).ⅢB~Ⅳ期组开始增高的时间[(6.59±5.24)月]比ⅢA组[(14.06±6.19)月]更短,差异有统计学意义(P<0.01).血清CYfra21-1起始水平、最低水平、开始增高时间、倍增时间、是否手术与Ⅲ、Ⅳ期肺鳞状细胞癌患者的预后有关(P<0.05).多因素预后分析提示治疗后最低血清CYfra21-1水平、开始增高时间、倍增时间是独立的预后因素.结论Ⅲ、Ⅳ期肺鳞状细胞癌治疗过程中最低血清CYfra21-1水平、血清CYfra21-1开始升高时间、倍增时间是CYfra21-1动态变化中最重要的预后因素.
목적연구혈청CYfra21-1재치료Ⅲ、Ⅳ기폐린상세포암과정중적동태변화급여예후적관계.방법선택생존기균<3년차치료진정중균출현혈청CYfra21-1적동태변화적폐린상세포암환자,기중ⅢA기조34례,ⅢB~Ⅳ기조32례.대ⅢA기급ⅢB~Ⅳ기환자적기시혈청CYfra21-1수평、최저혈청수평、개시증고시간、개시증고지사망시간、배증시간급년령진행비교.대시부수술급상술지표진행단인소예후분석,대단인소예후분석유의의적지표납입COX비례풍험회귀진행다인소예후분석.결과최저혈청CYfra21-1재ⅢA기조(1.97±1.79ng/ml)중현저저우ⅢB~Ⅳ기조(4.78±2.88ng/ml).ⅢB~Ⅳ기조개시증고적시간[(6.59±5.24)월]비ⅢA조[(14.06±6.19)월]경단,차이유통계학의의(P<0.01).혈청CYfra21-1기시수평、최저수평、개시증고시간、배증시간、시부수술여Ⅲ、Ⅳ기폐린상세포암환자적예후유관(P<0.05).다인소예후분석제시치료후최저혈청CYfra21-1수평、개시증고시간、배증시간시독립적예후인소.결론Ⅲ、Ⅳ기폐린상세포암치료과정중최저혈청CYfra21-1수평、혈청CYfra21-1개시승고시간、배증시간시CYfra21-1동태변화중최중요적예후인소.
Objective To investigate the relationship between dynamic changes of serum CYfra21-1 levels and progno-sis of Ⅲ-Ⅳ stage lung squamous cell carcinoma. Methods Thirty four patients with stage ⅢA and 32 patients with ⅢB-Ⅳstage lung squamous cel carcinoma were enrol ed in the study. The serum CYfra21-1 levels were measured at different time points. Univariate analysis was performed to test the factors influencing the prognosis and significant factors from univariate anal-ysis entered into Cox proportion Hazards regression model for multivariate analysis. Results The valley levels of serum CYfra21-1 inⅢA stage group(1.97±1.79ng/ml) were significantly lower than those inⅢB-Ⅳgroup(4.78±2.88ng/ml)(P=0.000). The rising of serum CYfra21-1 in ⅢB-Ⅳ stage (6.59±5.24months) was significantly earlier than that in ⅢA stage (14.06± 6.19months) (P=0.000). Univariate analysis showed that the baseline level, val ey level, increasing time and doubling time of serum CYfra21-1, as wel as the receiving surgery were related to prognosis ofⅢ-Ⅳstage squamous cel carcinoma. Multivari-ate analysis revealed that the val ey value, increasing time, doubling time of serum CYfra21-1were independently prognostic fac-torss. Conclusion The dynamic changes of serum CYfra21-1may provide information for prognosis of patients withⅢ-Ⅳstage lung squamous cell carcinoma.