Clinical Significance Of Serum Thymidine Kinase 1 In Evaluating Chemotherapy Efficacy And Prognosis Of Non-small Cell Lung Cancer

?Objective?To investigate the relationship between serum thymidine kinase 1 levels and the curative effect and long-term prognosis of patients with non-small cell lung cancer before and after treatment.?Methods?To collect peripheral blood samples of 88 patients with newly diagnosed or relapsed advanced non-small cell lung cancer.Serum levels of serum thymidine kinase 1,cytokeratin 19 fragment,carcinoembryonic antigen,carbohydrate antigen CA199,and carbohydrate antigen CA125 were measured before and after treatment for 2 cycles,4 cycles,6 cycles,and 8 cycles.To compare if there has statistical significance through the difference of serum level of TK1,CYFRA21-1,CEA,CA199 and CA125 before and after treatment.According to the Response Evaluation Criteria in Solid Tumors to assess the efficacy of 88 patients with non-small cell lung cancer after treatment.The patients with complete remission,partial remission and stable disease were recorded as effective group,with disease progression were recorded as ineffective group.Meanwhile,according to the standard of whether the serum thymidine kinase 1 level was higher than 2pM after 2 cycles treatment,divided the 82 patients with advanced non-small cell lung cancer who were regularly followed into high-level group and low-level group.Then evaluate if the difference of median survival between the two groups was statistical significant.?Results?1.The level of serum TK1 before treatment was significantly correlated with tumor cell differentiation(p=0.032).In contrast,there was no statistically significant difference in the gender,age,pathological type and smoking history of the patients.2.When first evaluated after treatment,serum levels of TK1,CYFRA21-1 and CA125 in the effective group were lower than those before treatment(P<0.05);serum levels of TK1,CYFRA21-1,and CA125 in the ineffective group were lower than before treatment,but did not have Statistical significance(P>0.05);After treatment,serum CEA,CA199 levels in the effective group and ineffective group were higher than before treatment.3.In the follow-up therapeutic evaluation of the treatment,serum TK1 levels in the effective group were lower than before in the second evaluation(P=0.017).Serum TK1 levels in the ineffective group were higher than before,but the difference was not significant.Statistically significant(P=0.445).In the third and fourth assessments,the levels of serum TK1 in the active and ineffective groups were not significantly different from those before,and the difference was not statistically significant(P>0.05).The serum CYFRA21-1?CA125 level of the effective treatment group had no significant changes compared with the previous(P>0.05).In the treatment ineffective group,the serum CYFRA21-1 level was significantly higher than before(P<0.05),the serum CA125 level also showed a higher trend than before.4.After treatment,the recurrence rate of patients with sTK1 up to PR group within 18 months was lower than that of patients with SD and PD(33.3% vs 56.8%,P=0.029).The recurrence-free survival time of PR group was longer than that of SD and PD patients.There is statistical significance(P=0.030).5.After treatment,the median survival period of patients with low-level of serum TK1,CYFRA21-1,CEA and CA199 was longer than the high-level group,and the difference was statistically significant(p<0.01).The median survival period of patients with low-level of serum CA125 was prlonged slightly compared with the high-level group,but the difference was not statistically significant(P=0.583).?Conclusion?1.Changes in serum levels of TK1,CYFRA21-1,and CA125 after treatment can be used to evaluate initial treatment outcome in patients with non-small cell lung cancer,For the evaluation of the curative effect of the later treatment,serum TK1 did not show a guiding value;however,elevated levels of CYFRA21-1 and CA125 had certain clinical significance in judging the poor curative effect of the later treatment.2.Changes in serum TK1 levels aftertreatment can be used to predict the risk of disease recurrence and relapse-free survival in patients with non-small cell lung cancer.3.The serum TK1,CYFRA21-1,CEA,CA199 level after treatment can be used to assess the long-term survival prognosis of non-small cell lung cancer patients.