CAJ | 학술논문

目的：探讨治疗前血清神经元特异性烯醇化酶（ NSE）水平在预测晚期非小细胞肺癌（ NSCLC）发生脑转移和患者预后的价值。方法回顾性分析128例晚期NSCLC患者的临床病理特征和治疗前血清NSE、癌胚抗原（ CEA）、细胞角蛋白21?1片段（ cyfra 21?1）、白蛋白（ ALB）、白细胞（ WBC）水平与NSCLC患者发生脑转移及其预后的关系。结果128例晚期NSCLC患者中，肺腺癌90例，肺鳞癌30例，大细胞未分化癌8例。血清NSE、CEA和cyfra 21?1的中位水平分别为13．6、7．8和6．1 ng／ml，ALB和WBC水平分别为（35．41±5．60）g／L和（8．16±2．53）×109／ml。多因素Logistic分析结果显示，NSE水平与NSCLC患者脑转移有关（ P＝0．030）。28例脑转移患者和98例无脑转移患者治疗前NSE水平分别为（34．18±28．48）ng／ml和（13．87±4．49）ng／ml，差异有统计学意义（P＜0．05）。治疗前NSE水平升高组和NSE水平正常组患者的中位生存时间分别为3．5个月和10．7个月，差异有统计学意义（P＜0．05）。结论治疗前血清NSE水平与NSCLC患者脑转移和预后有关，可作为晚期NSCLC脑转移的预测因素，治疗前血清NSE高水平提示NSCLC患者预后较差。
목적：탐토치료전혈청신경원특이성희순화매（ NSE）수평재예측만기비소세포폐암（ NSCLC）발생뇌전이화환자예후적개치。방법회고성분석128례만기NSCLC환자적림상병리특정화치료전혈청NSE、암배항원（ CEA）、세포각단백21?1편단（ cyfra 21?1）、백단백（ ALB）、백세포（ WBC）수평여NSCLC환자발생뇌전이급기예후적관계。결과128례만기NSCLC환자중，폐선암90례，폐린암30례，대세포미분화암8례。혈청NSE、CEA화cyfra 21?1적중위수평분별위13．6、7．8화6．1 ng／ml，ALB화WBC수평분별위（35．41±5．60）g／L화（8．16±2．53）×109／ml。다인소Logistic분석결과현시，NSE수평여NSCLC환자뇌전이유관（ P＝0．030）。28례뇌전이환자화98례무뇌전이환자치료전NSE수평분별위（34．18±28．48）ng／ml화（13．87±4．49）ng／ml，차이유통계학의의（P＜0．05）。치료전NSE수평승고조화NSE수평정상조환자적중위생존시간분별위3．5개월화10．7개월，차이유통계학의의（P＜0．05）。결론치료전혈청NSE수평여NSCLC환자뇌전이화예후유관，가작위만기NSCLC뇌전이적예측인소，치료전혈청NSE고수평제시NSCLC환자예후교차。
Objective To explore the value of serum neuron?specific enolase ( NSE ) before treatment in predicting brain metastases and prognosis of advanced non?small cell lung cancer ( NSCLC ) . Methods A total of 128 hospitalized patients with advanced NSCLC from Jan 2012 to Mar 2012 were followed up, and their clinicopathological data, serum NSE, carcinoembryonic antigen, cytokeratin 21?1 ( cyfra21?1 ) levels, albumin ( ALB ) , white blood cell ( WBC ) before treatment were analyzed retrospectively to determine the factors affecting brain metastasis and prognosis of advanced NSCLC. Results Among the 128 NSCLC patients, 90 cases were of adenocarcinoma, 30 cases were of squamous cell carcinoma, and 8 cases were of large cell carcinoma. The median levels of pre?treatment NSE, CEA and cyfra21?1 were 13.6 ng/ml, 7.8 ng/ml and 6.1 ng/ml, respectively. The average levels of ALB and WBC were(35.41±5.60)g/L and (8.16±2.53)×109/ml, respectively. Multi?variate logistic regression analysis showed that serum NSE before treatment was associated with brain metastasis of advanced NSCLC ( P=0.030). Pre?treatment NSE levels were (34.18±28.48) ng/ml in 28 patients with brain metastasis and (13.87±4.49) ng/ml in 98 patients without brain metastasis (P<0.05). The median survival time were 3.5 months in patients with normal levels of NSE, and 10.7 months in patients with elevated levels of NSE pre?treatment(P<0.05). Conclusions A higher pre?treatment level of NSE is closely correlated with brain metastasis of advanced NSCLC, and can be used as a predictor of brain metastases in advanced NSCLC. High pre?treatment levels of NSE indicate a poor prognosis in advanced NSCLC patients.