血清细胞角蛋白19片段（Cyfra 21-1）在非小细胞肺癌患者中的预后价值。

Prognostic value of serum cytokeratin 19 fragments (Cyfra 21-1) in patients with non-small cell lung cancer.

作者信息

Xu Youtao, Xu Lei, Qiu Mantang, Wang Jie, Zhou Qing, Xu Lin, Wang Jian, Yin Rong

机构信息

1] Department of Thoracic Surgery, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Key Laboratory of Molecular and Translational Cancer Research, Cancer Institute of Jiangsu Province, Baiziting 42, Nanjing, P.R. China, 210009 [2] The First Clinical College of Nanjing Medical University, Nanjing, 210000, China.

Department of Thoracic Surgery, The Affiliated Jiangning Hospital of Nanjing Medical University, No. 168 Dongshan Street Gushan Road, Nanjing 211100, China.

出版信息

Sci Rep. 2015 Apr 22;5:9444. doi: 10.1038/srep09444.

The role of serum CYFRA 21-1 level in patients with non-small cell lung cancer (NSCLC) remains to be defined. To re-evaluate the impact of serum CYFRA 21-1 in NSCLC survival, we performed this meta-analysis. Databases were searched to identify relevant studies reported after the publication of a meta-analysis in 2004. Totally, 31 studies with 6394 patients were included in this meta-analysis. The pooled Hazard ratios (HRs) indicated that high CYFRA 21-1 level was associated with poor prognosis on overall survival (OS) in patients with NSCLC (HR = 1.60; 95%CI = 1.36-1.89; P < 0.001). The pooled HRs were 2.18 (95%CI = 1.70, 2.80; P = 0.347) for patients at stage I-IIIA and 1.47 (95%CI = 1.02, 2.11; P < 0.001) for stage IIIB-IV. When stratified by surgical intervention, pooled HRs were 1.94 (95%CI = 1.42-2.67; P < 0.001) for studies with surgery and 1.24 (95%CI = 0.79-1.95; P < 0.001) for studies without surgery. Significant associations were also found in the patients treated with EGFR-TKIs (HR = 1.83; 95%CI = 1.31-2.58; P = 0.011) and platinum-based regimen (HR = 1.53; 95%CI = 1.18-1.99; P = 0.001). Meta-analysis of CYFRA 21-1 related to PFS was performed and pooled HR was 1.41 (95%CI = 1.19-1.69; P < 0.001). Our results indicate that high level of serum CYFRA 21-1 is a negative prognostic indicator of patients with NSCLC.

血清细胞角蛋白片段21-1（CYFRA 21-1）水平在非小细胞肺癌（NSCLC）患者中的作用仍有待明确。为了重新评估血清CYFRA 21-1对NSCLC患者生存的影响，我们进行了这项荟萃分析。检索数据库以识别2004年一项荟萃分析发表后报道的相关研究。本荟萃分析共纳入31项研究，涉及6394例患者。汇总的风险比（HRs）表明，CYFRA 21-1水平升高与NSCLC患者的总生存期（OS）预后不良相关（HR = 1.60；95%CI = 1.36 - 1.89；P < 0.001）。I-IIIA期患者的汇总HR为2.18（95%CI = 1.70, 2.80；P = 0.347），IIIB-IV期患者为1.47（95%CI = 1.02, 2.11；P < 0.001）。按手术干预分层时，有手术的研究汇总HR为1.94（95%CI = 1.42 - 2.67；P < 0.001），无手术的研究为1.24（95%CI = 0.79 - 1.95；P < 0.001）。在接受表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）治疗的患者（HR = 1.83；95%CI = 1.31 - 2.58；P = 0.011）和铂类方案治疗的患者（HR = 1.53；95%CI = 1.18 - 1.99；P = 0.001）中也发现了显著相关性。对与无进展生存期（PFS）相关的CYFRA 21-1进行荟萃分析，汇总HR为1.41（95%CI = 1.19 - 1.69；P < 0.001）。我们的结果表明，血清CYFRA 21-1水平升高是NSCLC患者的不良预后指标。