Correlation Of Tumor Markers With The Therapeutic Efficacy And Prognosis In Advanced Non-small Cell Lung Cancer

Objective: To investigate the relationships between carcinoembryonic antigen(CEA), neuron-specific enolase (NSE), cytokeratin19fragment antigen(CYFRA21-1),serum levels of lactate dehydrogenase (LDH) and the therapeutic efficacy, and analyzetheir impact on the prognosis of patients with advanced non-small cell lung cancer byretrospective study.Materials and Methods: Collecting the clinical and pathological data of273patients in the Second Affiliated Hospital of Dalian Med ical University from January2008to June2013who have been diagnosed to be local advanced or metastaticnon-small cell lung cancer (ⅢB or Ⅳ stage) by the cytology or pathology. The levelsof serum CEA, NSE, CYFRA21-1and LDH was detected when the patients were firstadimitted to hospital or before the beginning of chemotherapy. The relationshipsbetween the four tumor markers and gender, age, histological type, clinical stage,therapeutic effect or prognosis of the advanced NSCLC were analyzed by SPSS17.0statistical software, and the value of the four kinds of tumor markers in predictingtherapeutic efficacy and prognosis in patients with advanced NSCLC was evaluated.Results: This study showed that in patients with advanced NSCLC, the level ofserum CEA was correlated with gender, pathological type, clinical stage, therapeuticefficacy and prognosis. The level of serum CEA was significantly elevated in female patients compared with males (P<0.05); and also elevated in lung adenocarcinoma andstage Ⅳ patients (P<0.01); furthermore it was significantly correlated with therapeuticefficacy (P<0.05), if the serum CEA was elevated before the treatment, the PFS and OSwere significantly shorter (P<0.01).The level of NSE was correlated with the patient’s age, clinical stage, therapeuticefficacy and prognosis, and it was significantly higher in patients51-69years old thanthose≥70years (P<0.05); also higher in patients with stage Ⅳ than with stage ⅢB(P<0.05). The level of NSE was significantly lower when the treatment is effective (PR+SD)(P<0.01); and was increased when the disease progressed (P<0.05). The OSbecome shorter in those whose serum NSE was elevated (P<0.05), but in terms of PFS,there was no such statistically difference.The level of CYFRA21-1was correlated with pathological type, therapeuticefficacy and prognosis, and it was statistically higher in patients with squamous cellcarcinoma than in adenocarcinoma (P<0.05), and become lower when the response wasPR or SD (P<0.01); it also increased when the disease progressed (P<0.05). The OS andPFS become shorter in patients with elevated serum NSE (P<0.01).The level of Serum LDH was correlated with clinical staging, and it wasstatistically higher in stage Ⅳ than in stage Ⅲ B (P<0.05), but there was nodifferences between Serum LDH levels and gender, age, type of pathology, therapeuticefficacy and prognosis of advanced NSCLC.Conclusion:1. The levels of CEA, NSE and CYFRA21-1were significantlycorrelated with the therapeutic efficacy of the advanced NSCLC. The treatment efficacycan be predicted by monitoring the level of serum CEA, NSE and CYFRA21-1.2. In patients of advanced NSCLC with elevated serum CEA, NSE, CYFRA21-1,the PFS and OS were significantly shorter, so their prognosis can be preliminary judgedbased on the level of serum CEA, NSE and CYFRA21-1.3. The level of Serum LDH was correlated with clinical staging, and it wasstatistically higher in stage Ⅳ than in stage Ⅲ B, but the prognostic value foradvanced NSCLC is limited. 4. The levels of serum CEA, NSE and CYFRA21-1can be detected combined,which can improve the accuracy of estimation of prognosis and treatment efficacy of thepatients with advanced NSCLC.