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目的研究非小细胞肺癌患者手术前后血清细胞角蛋白19片段(cytokeratin 19 fragment,CA21-1)表达水平变化及意义。方法 2006年1月~2010年12月期间,收集非小细胞癌行外科手术切除治疗患者276例,采用ELISA法检测患者血清CEA(癌胚抗原,Carcino-embryonic antigen)、NSE(神经特异性烯醇化酶,Neuron-specific enolase)、SCC-Ag(鳞癌相关性抗原,Squamous cell carcinoma antigen)和CYFRA21-1水平,分析手术前后此四项血清肿瘤指标的表达水平变化,对各指标均数的变化采用组间t检验,计数资料采用组间χ2检验,检验水平P=0.05。结果 276例非小细胞癌行外科手术切除治疗患者手术前后的CA21-1水平进行了比较,结果显示非小细胞肺癌患者手术前血清CA21-1水平(6.5±1.6)μg/L,手术后(2.2±1.9)μg/L,二者相比较差异具有统计学意义(t=8.125,P﹤0.05)。手术前血清CA21-1阳性率51.8%(141/276),手术后17.8%(49/276),二者相比较差异具有统计学意义(χ2=18.325,P=0.000)。结论手术前后检测血清CA21-1水平有助于评估手术疗效,指导进一步的综合治疗,值得进一步临床推广应用。
Objective To study the changes and significance of serum cytokeratin 19 fragment (CA21-1) in patients with non-small cell lung cancer before and after operation. Methods From January 2006 to December 2010, 276 patients underwent surgical resection for non-small cell carcinoma. Serum levels of CEA (carcinoembryonic antigen), NSE (neuron specific enkephalin Neuron-specific enolase, SCC-Ag (Squamous cell carcinoma antigen) and CYFRA21-1 levels were analyzed before and after surgery to analyze the expression changes of these four serum tumor markers, Changes were used t test between groups, count data using the χ2 test, test level P = 0.05. Results A total of 276 non-small cell lung cancer patients undergoing surgical resection before and after surgery were compared with CA21-1 levels. The results showed that preoperative serum CA21-1 level was (6.5 ± 1.6) μg / L in patients with non-small cell lung cancer, 2.2 ± 1.9) μg / L, the difference was statistically significant (t = 8.125, P <0.05). The positive rate of serum CA21-1 before operation was 51.8% (141/276) and 17.8% (49/276) after operation. The difference was statistically significant (χ2 = 18.325, P = 0.000). Conclusion Preoperative and postoperative serum CA21-1 levels can be helpful to evaluate the curative effect and guide the further comprehensive treatment. It is worth further clinical application.