Gronowitz J S, Bergström R, Nôu E, Påhlman S, Brodin O, Nilsson S, Källander C F
Research Unit of Replication Enzymology, Uppsala University, Sweden.
Cancer. 1990 Aug 15;66(4):722-32. doi: 10.1002/1097-0142(19900815)66:4<722::aid-cncr2820660421>3.0.co;2-j.
The respective pretreatment prognostic impacts of the following markers were evaluated in 125 patients with small cell lung cancer (SCLC): lactic dehydrogenase (LDH), serum thymidine kinase (S-TK), carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), and tissue polypeptide antigen (TPA). More traditional clinical and serologic markers were also evaluated. Univariate analysis showed that all of the biochemical markers mentioned above, the Karnofsky index (KI) and the patient's sex were related to both the stage of disease (limited/extensive disease: LD/ED) and to survival. The strongest marker for the clinical stage was S-TK, whereas TPA showed the strongest relationship with survival. Multivariate analyses produced a model consisting of S-TK, CEA, NSE, and the patient's sex for determining the clinical stage. To compare the prognostic capacity of easily determined biochemical and simple clinical variables to the more resource-demanding variable of the clinical stage, three multivariate analyses in relation to survival were performed: (1) biochemical markers and simple clinical variables; (2) LD/ED and simple clinical variables; and (3) all available variables. The model obtained from the first analysis included TPA, KI, age, and the patient's sex; the model from the second analyses included LD/ED, patient's age, and KI; and the model from the third analysis, TPA, KI, age, sex, and LD/ED. Indices based on these three multivariate models were calculated for each patient and the prognostic capacity of these indices was compared. Pretreatment serum marker levels also had the capacity to predict both the grade and the duration of the response to therapy.
在125例小细胞肺癌（SCLC）患者中评估了以下标志物各自的预处理预后影响：乳酸脱氢酶（LDH）、血清胸苷激酶（S-TK）、癌胚抗原（CEA）、神经元特异性烯醇化酶（NSE）和组织多肽抗原（TPA）。还评估了更传统的临床和血清学标志物。单因素分析表明，上述所有生化标志物、卡诺夫斯基指数（KI）和患者性别均与疾病分期（局限期/广泛期：LD/ED）和生存率相关。用于临床分期的最强标志物是S-TK，而TPA与生存率的关系最为密切。多因素分析产生了一个由S-TK、CEA、NSE和患者性别组成的用于确定临床分期的模型。为了比较易于测定的生化和简单临床变量与对资源要求更高的临床分期变量的预后能力，进行了三项与生存率相关的多因素分析：（1）生化标志物和简单临床变量；（2）LD/ED和简单临床变量；（3）所有可用变量。第一次分析得到的模型包括TPA、KI、年龄和患者性别；第二次分析得到的模型包括LD/ED、患者年龄和KI；第三次分析得到的模型包括TPA、KI、年龄、性别和LD/ED。为每位患者计算基于这三个多因素模型的指数，并比较这些指数的预后能力。预处理血清标志物水平也有能力预测治疗反应的分级和持续时间。
