Zhu Wan-qi, Sun Xin-dong, Xie Peng, Kong Li, Yu Jin-ming
Department of Radiation Oncology, Shandong Tumor Hospital, Jinan 250117, China.
Zhonghua Zhong Liu Za Zhi. 2011 May;33(5):367-70.
The purpose of this study was to evaluate the potential of CYFRA 21-1 (CYFRA) and CEA as a prognostic marker in patients with undifferentiated nasopharyngeal carcinoma (NPC).
From March 2004 to February 2008, 62 patients with newly diagnosed, undifferentiated NPC were treated in our department. Their clinocopathological data were analyzed retrospectively. All patients received intensity-modulated radiotherapy using 6 MV X-rays, and serum CYFRA and CEA before and after radiotherapy were assayed. The association among the long-term follow-up results and age, sex, smoke, TNM stage, chemotherapy, CEA, CYFRA and the changes in any direction of serum CYFRA and CEA were determined.
Patients with low pre-RT level (≤ 2.49 µg/L) of CYFRA had a significantly better overall survival (OS) than patients with high level (> 2.49 µg/L,OR = 8.555, P = 0.029). N classification and T classification were positively associated with the prediction of progression free survival (OR = 4.054, P = 0.001;OR = 3.873, P = 0.001). But there was no significant association between the rest predictors (age, sex, CEA, post-RT CYFRA, chemotherapy and a radiation-induced decrease in serum markers) and the survival or recurrence rate by multivariate analysis.
The results of the present study show that pre-RT serum CYFRA level is a valuable factor for predicting long-term survival in patients with undifferentiated nasopharyngeal carcinoma. More aggressive treatment may be given to those patients with a high serum CYFRA level.
本研究旨在评估细胞角蛋白19片段(CYFRA 21-1,CYFRA)和癌胚抗原(CEA)作为未分化鼻咽癌(NPC)患者预后标志物的潜力。
2004年3月至2008年2月,我科收治62例新诊断的未分化NPC患者。回顾性分析其临床病理资料。所有患者均接受6 MV X线调强放疗,并检测放疗前后血清CYFRA和CEA水平。确定长期随访结果与年龄、性别、吸烟、TNM分期、化疗、CEA、CYFRA以及血清CYFRA和CEA任何方向变化之间的关联。
放疗前CYFRA水平低(≤2.49 μg/L)的患者总生存期(OS)明显优于水平高(>2.49 μg/L,OR = 8.555,P = 0.029)的患者。N分期和T分期与无进展生存期的预测呈正相关(OR = 4.054,P = 0.001;OR = 3.873,P = 0.001)。但多因素分析显示,其余预测因素(年龄、性别、CEA、放疗后CYFRA、化疗及放疗引起的血清标志物下降)与生存率或复发率之间无显著关联。
本研究结果表明,放疗前血清CYFRA水平是预测未分化鼻咽癌患者长期生存的一个有价值的因素。对于血清CYFRA水平高的患者,可能需要给予更积极的治疗。