格拉斯哥预后评分与晚期非小细胞肺癌患者血清肿瘤标志物的关系。
The relationship between Glasgow Prognostic Score and serum tumor markers in patients with advanced non-small cell lung cancer.
机构信息
Department of Respiratory Diseases, Jiangsu Taizhou People's Hospital, Yingchun Road 210#, Taizhou City, 225300, Jiangsu Province, P R China.
Nantong University, Qixiu Road 19#, Nantong city, 226001, Jiangsu Province, P R China.
出版信息
BMC Cancer. 2015 May 10;15:386. doi: 10.1186/s12885-015-1403-x.
BACKGROUND
Glasgow Prognostic Score (GPS) has been reported as a powerful prognostic tool for patients with advanced non-small cell lung cancer (NSCLC). The aim of this study was to assess the relationship between GPS and prognosis related tumor markers in patients with advanced NSCLC.
METHODS
We included 138 advanced NSCLC patients and twenty healthy controls in the study. GPS was calculated by combined serum C-reactive protein (CRP) and albumin. Three serum tumor markers, which included cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), carcinoembryonic antigen (CEA) and tissue polypeptide specific antigen (TPS), were detected by enzyme-linked immunosorbent assay (ELISA). GPS and tumor markers were all assessed before chemotherapy. All patients received at least 2 courses of cisplatin-based chemotherapy. After that, 2 to 5 years follow-up was conducted.
RESULTS
Median levels of CYFRA21-1 were 1.5 ng/ml (0.1-3.1 ng/ml) in healthy controls, and 4.6 ng/ml (0.7-35.2 ng/ml) in GPS 0 advanced NSCLC, 11.2 ng/ml (0.4-89.2) ng/ml in GPS 1 advanced NSCLC, and 15.7 ng/ml (2.9-134.6 ng/ml) in GPS 2 advanced NSCLC, respectively. Median levels of CYFRA21-1 were higher in NSCLC patients than in healthy controls, and CYFRA21-1 increased gradually according to GPS category in NSCLC patients (P< 0.05). Similar results were found for median levels of CEA and TPS in healthy controls and NSCLC patients (P < 0.05). In NSCLC patients, positive correlations were found between CYFRA21-1 and GPS, CEA and GPS, TPS and GPS. The Spearman's rank correlation coefficient were 0.67 (P < 0.05), 0.61 (P < 0.05) and 0.55 (P < 0.05), respectively. Survival analyses showed GPS was an independent prognostic factor for advanced NSCLC. CYFRA21-1(>3.3 ng/ml) and TPS (>80 U/l) were related with the prognosis of advanced NSCLC by univariate analyses, but multivariate analyses showed CYFRA21-1, TPS and CEA were not the independent prognostic factors for advanced NSCLC.
CONCLUSIONS
Our results showed GPS were positive correlated with CYFRA21-1, CEA and TPS in patients with advanced NSCLC. However, GPS was more efficient in predicting prognosis of advanced NSCLC than these three single prognosis related tumor markers.
背景
格拉斯哥预后评分（GPS）已被报道为晚期非小细胞肺癌（NSCLC）患者强有力的预后工具。本研究旨在评估 GPS 与晚期 NSCLC 患者预后相关肿瘤标志物之间的关系。
方法
我们纳入了 138 例晚期 NSCLC 患者和 20 例健康对照者。通过联合检测血清 C 反应蛋白（CRP）和白蛋白来计算 GPS。采用酶联免疫吸附试验（ELISA）检测三种血清肿瘤标志物，包括细胞角蛋白 19 片段抗原 21-1（CYFRA21-1）、癌胚抗原（CEA）和组织多肽特异性抗原（TPS）。在化疗前评估 GPS 和肿瘤标志物。所有患者均接受至少 2 个疗程的顺铂为基础的化疗。化疗后进行 2-5 年的随访。
结果
健康对照组 CYFRA21-1 的中位数水平为 1.5ng/ml（0.1-3.1ng/ml），GPS0 期晚期 NSCLC 患者为 4.6ng/ml（0.7-35.2ng/ml），GPS1 期晚期 NSCLC 患者为 11.2ng/ml（0.4-89.2ng/ml），GPS2 期晚期 NSCLC 患者为 15.7ng/ml（2.9-134.6ng/ml）。与健康对照组相比，NSCLC 患者的 CYFRA21-1 中位数水平更高，且根据 NSCLC 患者的 GPS 分类，CYFRA21-1 逐渐升高（P<0.05）。在健康对照组和 NSCLC 患者中，CEA 和 TPS 的中位数水平也有类似的结果（P<0.05）。在 NSCLC 患者中，CYFRA21-1 与 GPS、CEA 与 GPS、TPS 与 GPS 之间存在正相关关系。Spearman 秩相关系数分别为 0.67（P<0.05）、0.61（P<0.05）和 0.55（P<0.05）。生存分析表明 GPS 是晚期 NSCLC 的独立预后因素。单因素分析显示，CYFRA21-1（>3.3ng/ml）和 TPS（>80U/l）与晚期 NSCLC 的预后相关，但多因素分析显示，CYFRA21-1、TPS 和 CEA 不是晚期 NSCLC 的独立预后因素。
结论
我们的结果表明，GPS 与晚期 NSCLC 患者的 CYFRA21-1、CEA 和 TPS 呈正相关。然而，GPS 比这三种单一的预后相关肿瘤标志物更能有效地预测晚期 NSCLC 的预后。
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