术前 CYFRA 21-1 和 CEA 作为Ⅰ期非小细胞肺癌患者的预后因素。

Preoperative CYFRA 21-1 and CEA as prognostic factors in patients with stage I non-small cell lung cancer.

机构信息

Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Yahatanishi, Iseigaoka 1-1, Yahatanishi-ku, Kitakyushu 807, Japan.

出版信息

Lung Cancer. 2011 Oct;74(1):112-7. doi: 10.1016/j.lungcan.2011.02.001. Epub 2011 Mar 12.

DOI:10.1016/j.lungcan.2011.02.001

PMID:21397974

Abstract

PURPOSE

This study investigated the preoperative serum levels of CYFRA 21-1 and CEA as prognostic factors in patients with stage I non-small cell lung cancer.

SUBJECTS

This study evaluated 341 patients who had undergone a complete resection for stage I NSCLC between 2002 and 2008.

RESULTS

The patients included 193 males and 148 females. The mean age of the patients was 69.2 years (range: 19-88). The histological types included 264 adenocarcinomas, 56 squamous cell carcinomas, 11 large cell carcinomas, and 10 other types of carcinoma. A pneumonectomy was performed in 2 patients, a bilobectomy in 7, a lobectomy in 255, a segmentectomy in 46, and partial resection of the lung in 31 patients. The positive rates for CYFRA 21-1 in the adenocarcinoma and squamous cell carcinoma patients were 33.3% and 76.8%, respectively. The positive rates for CEA in adenocarcinoma and squamous cell carcinoma patients were 23.8% and 26.8%, respectively. The 5-year survival rate after surgery in the normal CYFRA 21-1 group and the high CYFRA 21-1 groups were 92.8% and 75.4%, respectively, in the patients with stage I NSCLC. There was a significant difference between the 2 groups (p<0.0001). The 5-year survival rate according to the serum level of CEA in the patients with stage I NSCLC were 88.3% for the normal group and 76.3% for the high group. In a multivariate analysis using the variables found to be significant prognostic factors in univariate analysis, a high CYFRA 21-1 level was found to be a significant independent prognostic factor (95% confidence interval 1.213-5.442, p=0.014).

CONCLUSION

A high preoperative CYFRA 21-1 level was a significant independent prognostic factor in patients with stage I NSCLC. The patients with a high CYFRA 21-1 level should carefully followed-up to rule out occult metastasis. Further clinical studies will be necessary to evaluate the efficacy of adjuvant therapy for the patients selected according to this criterion.

摘要

目的

本研究旨在探讨术前血清 CYFRA 21-1 和 CEA 水平作为Ⅰ期非小细胞肺癌患者的预后因素。

对象

本研究评估了 2002 年至 2008 年间接受完全切除术的 341 例Ⅰ期非小细胞肺癌患者。

结果

患者包括 193 名男性和 148 名女性。患者的平均年龄为 69.2 岁（范围：19-88 岁）。组织学类型包括 264 例腺癌、56 例鳞状细胞癌、11 例大细胞癌和 10 例其他类型的癌。2 例患者行全肺切除术，7 例行双肺叶切除术，255 例行肺叶切除术，46 例行肺段切除术，31 例行肺部分切除术。腺癌和鳞状细胞癌患者中 CYFRA 21-1 的阳性率分别为 33.3%和 76.8%。腺癌和鳞状细胞癌患者中 CEA 的阳性率分别为 23.8%和 26.8%。Ⅰ期非小细胞肺癌患者术后 CYFRA 21-1 正常组和高 CYFRA 21-1 组的 5 年生存率分别为 92.8%和 75.4%，两组间差异有统计学意义（p<0.0001）。根据Ⅰ期非小细胞肺癌患者血清 CEA 水平，正常组和高组的 5 年生存率分别为 88.3%和 76.3%。多变量分析显示，术前高 CYFRA 21-1 水平是独立的预后因素（95%置信区间 1.213-5.442，p=0.014）。