细胞角蛋白19片段21-1预测晚期非小细胞肺癌患者联合化疗免疫治疗的疗效：一项前瞻性观察研究。
CYFRA 21-1 predicts efficacy of combined chemoimmunotherapy in patients with advanced non-small cell lung cancer: a prospective observational study.
作者信息
Kataoka Nobutaka, Katayama Yuki, Yamada Tadaaki, Morimoto Kenji, Takeda Takayuki, Okada Asuka, Shiotsu Shinsuke, Chihara Yusuke, Hiranuma Osamu, Yamada Takahiro, Ota Takahiro, Harada Taishi, Hasegawa Isao, Nishioka Naoya, Iwasaku Masahiro, Tokuda Shinsaku, Takayama Koichi
机构信息
Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan.
出版信息
Transl Lung Cancer Res. 2024 Aug 31;13(8):1929-1937. doi: 10.21037/tlcr-24-190. Epub 2024 Aug 20.
BACKGROUND
Tumor markers such as serum carcinoembryonic antigen (CEA) and cytokeratin fragment 19 (CYFRA 21-1) are utilized for assessing the effectiveness of chemotherapy in non-small cell lung cancer (NSCLC) patients. Yet, it remains uncertain whether these markers can reliably forecast responses to combined chemoimmunotherapy. Our study aimed to examine the significance and effectiveness of these markers in predicting responses among NSCLC patients undergoing combined chemoimmunotherapy.
METHODS
This two-part observational study involved patients with NSCLC who were treated with combined chemoimmunotherapy in Japanese hospitals. An initial retrospective study of these patients, with serum CEA and CYFRA 21-1 as prognostic factors for combined chemoimmunotherapy outcomes, served as a discovery cohort. Patients in a subsequent prospective study served as a validation cohort, where we assessed the prognostic accuracy of CEA and CYFRA 21-1 cut-off points determined by the discovery cohort.
RESULTS
In total, 121 patients treated with combined chemoimmunotherapy were included, with 44 and 77 patients in the discovery and validation cohorts, respectively. Serum CYFRA 21-1 levels >3.0 ng/mL were significantly associated with progression-free survival (PFS) in both the discovery and validation cohorts (P=0.01, P=0.04, respectively). PFS did not differ significantly by CEA levels (P=0.21).
CONCLUSIONS
After combined chemoimmunotherapy treatment, serum CYFRA 21-1 stands out as a potentially valuable biomarker for predicting the prognosis of NSCLC.
背景
血清癌胚抗原（CEA）和细胞角蛋白片段19（CYFRA 21-1）等肿瘤标志物用于评估非小细胞肺癌（NSCLC）患者化疗的疗效。然而，这些标志物能否可靠预测联合化疗免疫治疗的反应仍不确定。我们的研究旨在探讨这些标志物在预测接受联合化疗免疫治疗的NSCLC患者反应中的意义和有效性。
方法
这项两部分的观察性研究纳入了在日本医院接受联合化疗免疫治疗的NSCLC患者。对这些患者进行初步回顾性研究，将血清CEA和CYFRA 21-1作为联合化疗免疫治疗结果的预后因素，作为发现队列。随后前瞻性研究中的患者作为验证队列，我们评估了发现队列确定的CEA和CYFRA 21-1临界值的预后准确性。
结果
总共纳入了121例接受联合化疗免疫治疗的患者，发现队列和验证队列分别有44例和77例患者。在发现队列和验证队列中，血清CYFRA 21-1水平>3.0 ng/mL均与无进展生存期（PFS）显著相关（分别为P=0.01，P=0.04）。PFS在CEA水平上无显著差异（P=0.21）。
结论
联合化疗免疫治疗后，血清CYFRA 21-1是预测NSCLC预后的潜在有价值生物标志物。
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