CAJ | 학술논문

目的：探究晚期非小细胞肺癌（NSCLC）患者血清癌胚抗原水平和全身转移能力的相关性。方法：选取2012年3月-2014年1月来本院治疗的初治IV期NSCLC患者160例为研究对象。研究指标包括年龄、身高、体重、性别、组织学分类、肿瘤分化、CEA水平、吸烟状况、骨转移、淋巴结转移、胸膜/积液转移、颈部转移、软组织转移、脑转移、全身转移得分及LN-调整全身转移得分。结果：不同CEA水平患者的性别、组织学分类、骨转移、淋巴结转移和脑转移比较差异具有统计学意义（P<0.05）；而年龄、肿瘤分化、吸烟状况、胸膜/积液转移、颈部转移和软组织转移比较差异无统计学意义（P>0.05）。血清CEA水平从LN-调整全身转移得分1分中的2.7 ng/mL上升至LN-调整全身转移得分7分中的374.1 ng/mL（P=0.003）。低LN-调整全身转移得分（评分1~3分）与高LN-调整全身转移得分（评分4~7分）比较表现出CEA水平显著降低，两组比较差异具有统计学意义（P<0.001）。血清高CEA水平的比例从全身转移得分1分中占37.5％（15/40）上升至全身转移得分6中的100％（1/1），两组比较差异具有统计学意义（P<0.001）。血清高CEA水平的比例从LN-调整全身转移得分1分中占25.0％（2/8）上升至LN-调整全身转移得分7分中的100％（1/1）（P<0.001）。单因素分析结果表明，性别、组织学分类、骨转移、淋巴结转移和脑转移是影响患者高CEA水平的危险因素；多因素Logistic回归分析表明，组织学分类OR（95% CI）=3.611（1.375-5.313）（P<0.001）、骨转移OR （95% CI）=3.513（1.856-4.637）（P<0.001）和脑转移OR（95% CI）=3.338（1.271-5.533）（P<0.001）是影响患者高CEA水平的独立危险因素。结论：血清高CEA水平与晚期非小细胞肺癌全身转移潜能增加密切相关。升高的血清CEA水平更加频繁地在骨转移、脑转移、淋巴结转移和肺转移患者中发现。目的：探究晚期非小細胞肺癌（NSCLC）患者血清癌胚抗原水平和全身轉移能力的相關性。方法：選取2012年3月-2014年1月來本院治療的初治IV期NSCLC患者160例為研究對象。研究指標包括年齡、身高、體重、性彆、組織學分類、腫瘤分化、CEA水平、吸煙狀況、骨轉移、淋巴結轉移、胸膜/積液轉移、頸部轉移、軟組織轉移、腦轉移、全身轉移得分及LN-調整全身轉移得分。結果：不同CEA水平患者的性彆、組織學分類、骨轉移、淋巴結轉移和腦轉移比較差異具有統計學意義（P<0.05）；而年齡、腫瘤分化、吸煙狀況、胸膜/積液轉移、頸部轉移和軟組織轉移比較差異無統計學意義（P>0.05）。血清CEA水平從LN-調整全身轉移得分1分中的2.7 ng/mL上升至LN-調整全身轉移得分7分中的374.1 ng/mL（P=0.003）。低LN-調整全身轉移得分（評分1~3分）與高LN-調整全身轉移得分（評分4~7分）比較錶現齣CEA水平顯著降低，兩組比較差異具有統計學意義（P<0.001）。血清高CEA水平的比例從全身轉移得分1分中佔37.5％（15/40）上升至全身轉移得分6中的100％（1/1），兩組比較差異具有統計學意義（P<0.001）。血清高CEA水平的比例從LN-調整全身轉移得分1分中佔25.0％（2/8）上升至LN-調整全身轉移得分7分中的100％（1/1）（P<0.001）。單因素分析結果錶明，性彆、組織學分類、骨轉移、淋巴結轉移和腦轉移是影響患者高CEA水平的危險因素；多因素Logistic迴歸分析錶明，組織學分類OR（95% CI）=3.611（1.375-5.313）（P<0.001）、骨轉移OR （95% CI）=3.513（1.856-4.637）（P<0.001）和腦轉移OR（95% CI）=3.338（1.271-5.533）（P<0.001）是影響患者高CEA水平的獨立危險因素。結論：血清高CEA水平與晚期非小細胞肺癌全身轉移潛能增加密切相關。升高的血清CEA水平更加頻繁地在骨轉移、腦轉移、淋巴結轉移和肺轉移患者中髮現。
목적：탐구만기비소세포폐암（NSCLC）환자혈청암배항원수평화전신전이능력적상관성。방법：선취2012년3월-2014년1월래본원치료적초치IV기NSCLC환자160례위연구대상。연구지표포괄년령、신고、체중、성별、조직학분류、종류분화、CEA수평、흡연상황、골전이、림파결전이、흉막/적액전이、경부전이、연조직전이、뇌전이、전신전이득분급LN-조정전신전이득분。결과：불동CEA수평환자적성별、조직학분류、골전이、림파결전이화뇌전이비교차이구유통계학의의（P<0.05）；이년령、종류분화、흡연상황、흉막/적액전이、경부전이화연조직전이비교차이무통계학의의（P>0.05）。혈청CEA수평종LN-조정전신전이득분1분중적2.7 ng/mL상승지LN-조정전신전이득분7분중적374.1 ng/mL（P=0.003）。저LN-조정전신전이득분（평분1~3분）여고LN-조정전신전이득분（평분4~7분）비교표현출CEA수평현저강저，량조비교차이구유통계학의의（P<0.001）。혈청고CEA수평적비례종전신전이득분1분중점37.5％（15/40）상승지전신전이득분6중적100％（1/1），량조비교차이구유통계학의의（P<0.001）。혈청고CEA수평적비례종LN-조정전신전이득분1분중점25.0％（2/8）상승지LN-조정전신전이득분7분중적100％（1/1）（P<0.001）。단인소분석결과표명，성별、조직학분류、골전이、림파결전이화뇌전이시영향환자고CEA수평적위험인소；다인소Logistic회귀분석표명，조직학분류OR（95% CI）=3.611（1.375-5.313）（P<0.001）、골전이OR （95% CI）=3.513（1.856-4.637）（P<0.001）화뇌전이OR（95% CI）=3.338（1.271-5.533）（P<0.001）시영향환자고CEA수평적독립위험인소。결론：혈청고CEA수평여만기비소세포폐암전신전이잠능증가밀절상관。승고적혈청CEA수평경가빈번지재골전이、뇌전이、림파결전이화폐전이환자중발현。
Objective: To study the serum level of carcinoembryonic antigen and whole-body metastasis ability risk in patients with advanced non-small cell lung cancer,and provide the reference for clinical.Method: 160 patients with stage IV NSCLC in our hospital from March 2012 to January 2014 were selected. Research indicators included age, height,weight,age,sex,histological classification,tumor differentiation ,CEA level,smoking status,bone metastases,lymphatic metastasis,obstinate/transfer, transfer, soft tissue of neck metastases, brain metastases, systemic metastasis score and systemic metastasis LN-adjustment score, and the statistical analysis was performed.Result: The sex,bone metastases,histological classification lymph node metastasis and brain metastasis of different CEA level patients had statistical significance (P<0.05),but the age, smoking status, tumor differentiation, obstinate/transfer, transfer, and soft tissue of neck metastases showed no statistical difference(P>0.05).Serum CEA level increased from 2.7 ng/mL in LN-adjusted whole-body metastatic score 1 to 374.1 ng/mL in LN-adjusted whole-body metastatic score 7,the difference was statistically significant (P=0.003).Similarly, the low LN-adjusted whole-body metastatic score (rating 1-3) showed CEA level significantly reduced when compared with adjustment of high LN-adjusted whole-body metastatic score (rating 4-7),the difference was statistically significant(P<0.001).Scores of high CEA levels in serum from 37.5%(15/40) in LN-adjusted whole-body metastatic score 1 rose to 100%(1/1) in LN-adjusted whole-body metastatic score 6, the difference was statistically significant(P<0.001).Similarly, high serum CEA score rose from 25% (2/8) in LN-adjusted whole-body metastatic score 1 rose to 100%(1/1) in LN-adjusted whole-body metastaticscore 7, the difference was statistically significant(P<0.001).Univariate analysis results showed that gender, bone metastases, histological classification and lymph node metastases and brain metastasis were risk factors of high CEA level, multivariate Logistic regression analyses showed that the histological classification OR(95% CI)=3.611(1.375-5.313) (P<0.001),bone metastases OR(95% CI)=3.513(1.856-4.637)(P<0.001),and brain metastases OR(95% CI)=3.338(1.271-5.533)(P<0.001)were independent risk factor of the influence of high CEA level.Conclusion: High serum CEA level and systemic metastasis increases with advanced non-small cell lung cancer are closely related. High serum CEA level is more frequently in bone metastases, brain metastasis, lymph node metastasis and lung metastasis patients.