肿瘤标志物GSTP1、CYFRA21-1 及SCC-Ag 对非小细胞肺癌的预后评估价值

Prognostic value of combined detection of tumor markers GSTP1, CYFRA21-1 and SCC-Ag in NSCLC

摘要:

目的 探讨肿瘤标志物GSTP1、CYFRA21-1、SCC-Ag 对非小细胞肺癌（NSCLC）的预后评 估价值。方法 选取2016 年6 月—2018 年6 月华北理工大学附属医院收治的600 例NSCLC 患者作为实验组， 另选取同期该院200 例健康体检者作为对照组。采用电化学发光免疫分析法检测血清GSTP1、CYFRA21-1 水平，ELISA 法检测血清SCC-Ag 水平，比较血清GSTP1、CYFRA21-1 及SCC-Ag 水平的差异性，评价3 种肿瘤标志物水平与患者生存时间的关系。结果 实验组血清GSTP1、CYFRA21-1 及SCC-Ag 水平高于对 照组（P <0.05）。不同性别、年龄及是否吸烟的患者血清GSTP1、CYFRA21-1、SCC-Ag 水平比较，差异无 统计学意义（P >0.05）。肺腺癌患者血清GSTP1 水平高于肺鳞癌、肺腺鳞癌和大细胞肺癌患者（P <0.05）， 大细胞肺癌和肺腺鳞癌患者血清GSTP1 水平高于肺鳞癌患者（P <0.05）。肺鳞癌患者血清CYFRA21-1 和SCC-Ag 水平高于肺腺癌、肺腺鳞癌和大细胞肺癌患者（P <0.05），肺腺鳞癌患者血清CYFRA21-1 和 SCC-Ag 水平高于大细胞肺癌和肺腺癌患者（P <0.05），临床分期Ⅰ、Ⅱ期患者血清GSTP1、CYFRA21-1 及SCC-Ag 水平低于Ⅲ、Ⅳ期患者（P <0.05），Ⅲ期患者血清GSTP1、CYFRA21-1 及SCC-Ag 水平低 于Ⅳ期患者（P <0.05），血清肿瘤标志物水平随分期升高逐渐上升。生存时间<1 年的患者血清GSTP1、 CYFRA21-1、SCC-Ag 水平高于生存时间≥ 1 年的患者（P <0.05）。ROC 曲线结果显示，3 者联合检测预 测1 年内患者死亡的敏感性为93.92%（95% CI ：0.817，0.980），特异性为50.00%（95% CI ：0.424，0.609）。 结论 肿瘤标志物GSTP1、CYFRA21-1 及SCC-Ag 对NSCLC 的预后评估具有一定的应用价值。

Abstract:

Objective To investigate the prognostic value of tumor markers GSTP1, CYFRA21-1 and SCC-Ag in non-small cell lung cancer (NSCLC). Methods A total of 600 patients with NSCLC admitted to our hospital from June 2016 to June 2018 were enrolled in this study. Another 200 healthy people who underwent physical examination in our hospital during the same period were taken as control group. The levels of serum GSTP1 and CYFRA21-1 were detected by electrochemiluminescence immunoassay. The levels of serum SCC-Ag level was detected by ELISA. The differences of serum GSTP1, CYFRA21-1 and SCC-Ag levels between NSCLC patients and healthy people were compared. The relationship between GSTP1, CYFRA21-1, SCC-Ag and survival time was evaluated. Results The levels of GSTP1, CYFRA21-1 and SCC-Ag in the experimental group were significantly higher than those in the control group (P < 0.05). There was no significant difference in the levels of GSTP1, CYFRA21-1 and SCC-Ag between the patients of different genders, ages and smoking or not (P > 0.05). GSTP1 levels in lung adenocarcinoma group, lung squamous cell carcinoma group, lung adenocarcinoma group and large cell lung cancer group were compared by one-way ANOVA, the difference was statistically significant (P < 0.05). The serum GSTP1 level in patients with lung adenocarcinoma was higher than that in patients with lung squamous cell carcinoma, lung adenosquamous carcinoma and large cell lung cancer (P < 0.05). The serum GSTP1 level in patients with large cell lung cancer was higher than that in patients with lung squamous cell carcinoma (P < 0.05). The serum GSTP1 level in patients with lung adenosquamous carcinoma was higher than that in patients with lung squamous carcinoma (P < 0.05). The levels of CYFRA21-1 and SCC-Ag in the the lung adenocarcinoma group were higher than those in the lung adenocarcinoma group, the lung squamous cell carcinoma group and the large cell lung cancer group (P < 0.05). The levels of serum CYFRA21-1 and SCC Ag in patients with lung adenocarcinoma were higher than those in patients with large cell lung cancer and lung adenocarcinoma (P < 0.05). GSTP1, CYFRA21-1 and SCC-Ag levels in patients with stage I and II were statistically higher than those in patients with stage III and IV (P < 0.05). The ROC curve showed that the combination of GSTP1, CYFRA21-1 and SCC-Ag had statistical significance in predicting the death within one year, the sensitivity was 93.92% (95% CI: 0.817, 0.980), and the specificity was 50.00% (95% CI: 0.424, 0.609). Conclusions The tumor markers GSTP1, CYFRA21-1 and SCC-Ag have certain value in the prognosis evaluation of NSCLC.