【作者】 赵同伟； 卢丽琴； 钦志泉； 袁国荣； 高亮； 陈永健； 孙馨； 陈韵； 洪朝金； 杨思福；

【Author】 Zhao Tongwei,Lu Liqin,Qin Zhiquan,et al.Oncology Department,Zhejiang Provincial People s Hospital,Hangzhou,310014,China

【机构】 浙江省人民医院肿瘤科； 浙江省人民医院检验中心；

【摘要】 目的本研究通过分析晚期非细胞肺癌(non-small cell lung cancer,NSCLC)患者2周期化疗前后CEA的变化来研究其在评价影像学肿瘤疾病控制(disease control,DC)的效能和预后的价值,为是否需要调整治疗方案提供依据。方法回顾性分析53例NSCLC患者化疗前、2周期化疗后血液中CEA变化;应用受试者工作特征曲线(receiver operating characteristics curve,ROC)来评价CEA变化对于化疗后影像学DC的评价效能;探讨CEA变化和预后的关系。结果 CEA变化率评价DC的ROC曲线下面积为0.794,CEA变化率阈值为-34.0%,此时敏感度和特异度为分别80.0%和87.5%。spearman相关分析知CEA变化和DC呈明显正相关(r=0.526,P<0.01)。单因素生存分析知CEA变化阳性的患者肿瘤无疾病进展时间(progression-free survival,PFS)明显长于阴性患者(中位值分别是6.87月和2.77月,P<0.05)。COX多因素风险回归模型进一步分析知CEA变化也是预测PFS的独立预后因子(P<0.05)。化疗周期数、体重变化也均是预测PFS的独立预后因子(P<0.05)。结论在CEA水平升高的晚期NSCLC患者中,2周期化疗前后CEA变化可以有效评价影像学DC和预测PFS,CEA变化可作为影像学评价的重要辅助工具,有利于全面评估疗效。更多还原

【Abstract】 Objective The aim of this study was to explore evaluation of radiological disease control(DC) and prognosis of CEA change pre- and post-chemotherapy of 2 cycles in patients with advanced non-small-cell lung cancer(NSCLC).It may help to provide evidence on whether therapeutic schedule need be regulated.Methods The changes of serum CEA levels in 53 patients with NSCLC of pre- and post-chemotherapy of 2 cycles were retrospectively investigated.Application of receiver operating characteristic curve(ROC) in evaluation of efficacy of CEA change in evaluation of DC.The correlation of CEA change and prognosis was explored also.Results When the change rates of the CEA levels were used to evaluate DC of patients,the area of ROC curve was 0.794.And when the cut-point of the change rates of CEA levels was -34.0%,the sensitivity and specificity were respectively 80.0%and 87.5%.Spearman correlation regression analysis confirmed that CEA change was in obviously positive correlation with DC((r=0.526,P<0.01).Univariate survival analysis showed that the progression-free survival(PFS) of positive patients in CEA change was much longer than the one of negative patients(media PFS 6.87 months and 2.77 months respectively,P<0.05).Multivariate survival analysis confirmed that CEA change was also an independent prognosis factor of prediction of PFS(P<0.05).The chemotherapy cycles and loss of weight were all independent prognosis factors in PFS among NSCLC patients (P<0.05).Conclusion CEA change can effectively evaluate DC and predict PFS in advanced NSCLC patients with increased CEA levels.It was proven to be the important auxiliary tool of radiological evaluation and is in favor of overall evaluation of therapeutic effect.更多还原