多项肺系统肿瘤标志物异常在晚期肺腺癌治疗中的作用

BACKGROUND AND OBJECTIVE: Among frequently-used tumor markers in lung cancer, carcinoembryonic antigen (CEA) and carbohydrate antigen 125 (CA125), cytokeratin 19 (CYFRA21-1) and squamous carcinoma antigen (SCC), neuron specific enolase (NSE) and pro-gastrin-releasing peptide (ProGRP) are respectively expressed highly in lung adenocarcinoma, lung squamous carcinoma and small cell lung cancer. By comparing patients with multiple increased tumor markers (group A) and patients with increase of CEA and/or CA125 (group B), this study aims to investigate the utility of multiple increased tumor markers in therapeutic evaluation and prediction of disease relapsing in patients with advanced lung adenocarcinoma. METHODS: Patients with stage Ⅳ lung adenocarcinoma who receiving the first line chemotherapy in Cancer Hospital, Chinese Academy of Medical Sciences were enrolled and retrospectively analyzed. Clinical characteristic, serum tumor markers before chemotherapy, efficacy evaluation, progression-free survival (PFS) were analyzed. RESULTS: Except CEA and CA125, the highest ratio of increased tumor markersin group A was CYFRA21-1 (93%), then was NSE (36%), SCC (13%) and ProGRP (12%). Patients with multiple increased tumor markers tend to have more distant metastasis (P < 0.001) and shorter PFS (median PFS 5.3 months vs 7.3 months, P=0.016). The relapse risk was lower in patients who accepted maintenance therapy than those who didn't accept maintenance therapy in both groups (P < 0.001). CONCLUSION: Patients with multiple increased tumor markers have high risk of relapse, and maintenance therapy can reduce relapse risk.