组织多肽特异性抗原、细胞角蛋白片段21-1及癌胚抗原在非小细胞肺癌中的评估：联合使用细胞角蛋白标志物是否能提供更多信息？

Evaluation of tissue polypeptide specific antigen, CYFRA 21-1, and carcinoembryonic antigen in nonsmall cell lung carcinoma: does the combined use of cytokeratin markers give any additional information?

作者信息

Nisman B, Lafair J, Heching N, Lyass O, Baras M, Peretz T, Barak V

机构信息

Oncology Department, Hadassah University Hospital, Jerusalem, Israel.

出版信息

Cancer. 1998 May 15;82(10):1850-9. doi: 10.1002/(sici)1097-0142(19980515)82:10<1850::aid-cncr6>3.0.co;2-r.

DOI:10.1002/(sici)1097-0142(19980515)82:10<1850::aid-cncr6>3.0.co;2-r

PMID:9587116

Abstract

BACKGROUND

Recently developed tissue polypeptide specific antigen (TPS) and CYFRA 21-1 assays determine the soluble cytokeratin 18 and 19 fragments, respectively, in serum. The authors compared the value of TPS, CYFRA 21-1, and carcinoembryonic antigen (CEA) for the diagnosis, staging, prognosis, and monitoring of patients with nonsmall cell lung carcinoma (NSCLC).

METHODS

The study included 85 patients with benign lung diseases and 94 patients with NSCLC. TPS, CYFRA 21-1, and CEA serum levels were measured with commercial kits.

RESULTS

The following were demonstrated: 1) CYFRA 21-1 and TPS levels, but not CEA levels, differed significantly between NSCLC patients with operable disease (Stages I-IIIA) and those with inoperable disease (Stages IIIB-IV). 2) The correlation coefficient between CYFRA 21-1 and TPS increased with the progression of NSCLC from Stages I-IIIA (r = 0.41, P = 0.04) to Stages IIIB-IV (r = 0.70, P < 0.001). 3) Multivariate analysis identified TPS and CYFRA 21-1 as significant predictors of survival, with relative risks of 2.57 (P = 0.001) and 2.05 (P = 0.01), respectively. For cases in which both cytokeratin markers were positive, the relative risk was 6.4 (P < 0.0001) compared with cases in which both were negative. 4) For the group with inoperable disease, the combined use of TPS and CYFRA 21-1 allowed for the definition of 3 sets of patients with significantly different median survival times (14.3 months vs. 7.4 months vs. 2.6 months). 5) The percentages of marker evaluations concordant with results of clinical assessments of response to therapy were 75.0%, 72.2%, and 61.1% for CYFRA 21-1, TPS, and CEA, respectively.

CONCLUSIONS

These findings suggest that, for NSCLC patients, CYFRA 21-1 and TPS are significant prognostic factors and effective monitors of therapy. The combined use of these cytokeratin markers may provide additional information for prognosis.

摘要

背景

最近研发的组织多肽特异性抗原（TPS）和细胞角蛋白19片段（CYFRA 21-1）检测分别测定血清中可溶性细胞角蛋白18和19片段。作者比较了TPS、CYFRA 21-1和癌胚抗原（CEA）在非小细胞肺癌（NSCLC）患者诊断、分期、预后及监测中的价值。

方法

该研究纳入85例良性肺病患者和94例NSCLC患者。使用商用试剂盒测定TPS、CYFRA 21-1和CEA的血清水平。

结果

结果表明：1）可手术疾病（I-IIIA期）的NSCLC患者与不可手术疾病（IIIB-IV期）的NSCLC患者之间，CYFRA 21-1和TPS水平有显著差异，但CEA水平无显著差异。2）CYFRA 21-1与TPS之间的相关系数随NSCLC从I-IIIA期（r = 0.41，P = 0.04）进展到IIIB-IV期（r = 0.70，P < 0.001）而升高。3）多变量分析确定TPS和CYFRA 21-1为生存的显著预测因子，相对风险分别为2.57（P = 0.001）和2.05（P = 0.01）。对于两种细胞角蛋白标志物均为阳性的病例，与均为阴性的病例相比，相对风险为6.4（P < 0.0001）。4）对于不可手术疾病组，联合使用TPS和CYFRA 21-1可将患者分为3组，其生存中位数有显著差异（14.3个月对7.4个月对2.6个月）。5）CYFRA 21-1、TPS和CEA与治疗反应临床评估结果一致的标志物评估百分比分别为75.0%、72.2%和61.1%。