摘要
目的:分析晚期非小细胞肺癌(NSCLC)患者血清胃泌素前体释放肽(ProGRP)、神经特异性烯醇化酶(NSE)和细胞角蛋白19片段21-1(CYFRA21-1)表达与表皮生长因子受体-酪氨酸激酶抑制剂(EGFR-TKIs)治疗效果关系。方法:选取2022年1月至2024年5月于河南科技大学第一附属医院给予EGFR-TKIs治疗的106例晚期NSCLC患者,治疗3个月后,根据治疗效果分为疾病控制组(n=79)和疾病进展组(n=27)。收集两组患者的一般资料,采用化学发光法检测ProGRP,NSE和CYFRA21-1水平,比较两组患者的一般资料及ProGRP,NSE和CYFRA21-1水平;Logistic回归分析晚期NSCLC患者疗效的影响因素;受试者工作特征曲线(ROC曲线)评价ProGRP,NSE和CYFRA21-1水平对EGFR-TKIs治疗晚期NSCLC患者疗效的预测价值。结果:疾病控制组临床分期为Ⅳ期的NSCLC患者较疾病进展组占比少(35.44%vs 70.37%)(χ^(2)=9.947,P<0.05);疾病控制组肿瘤低分化的NSCLC患者较疾病进展组占比少(40.51%vs 62.96%)(χ^(2)=4.082,P<0.05);疾病控制组NSCLC患者ProGRP、NSE、CYFRA21-1水平均低于疾病进展组(P<0.05)。Logistic回归分析显示,ProGRP、NSE、CYFRA21-1水平、临床分期、肿瘤分化程度均为影响EGFR-TKIs治疗晚期NSCLC疗效的因素。行ROC曲线分析发现ProGRP、NSE、CYFRA21-1水平预测EGFR-TKIs治疗晚期NSCLC疗效AUC分别为0.803、0.654和0.771,联合诊断AUC为0.900,灵敏度和特异度分别为81.50%和93.65%。结论:ProGRP、NSE、CYFRA21-1水平、临床分期、肿瘤分化程度均为EGFR-TKIs治疗晚期NSCLC疗效的影响因素。ProGRP、NSE、CYFRA21-1水平对EGFR-TKIs治疗晚期NSCLC疗效均有一定的预测价值,且联合预测效能更高。
Objective:To analyze the relationship between the expression of serum pro-gastrin-releasing peptide(ProGRP),neuron-specific enolase(NSE),and cytokeratin 19 fragment 21-1(CYFRA21-1)and the therapeutic effect of epidermal growth factor receptor-tyrosine kinase inhibitors(EGFR-TKIs)in patients with advanced non-small cell lung cancer(NSCLC).Methods:106 patients with advanced NSCLC who received EGFR-TKIs treatment at the First Affiliated Hospital of Henan University of Science and Technology from January 2022 to May 2024 were selected.After three months of treatment,the patients were divided into a disease control group(n=79)and a disease progression group(n=27)based on the therapeutic effect.General information of the two groups was collected.The levels of ProGRP,NSE and CYFRA21-1 were detected using the chemiluminescence method.The general information and levels of ProGRP,NSE and CYFRA21-1 between the two groups were compared.Logistic regression analysis was used to identify the influencing factors of the therapeutic effect in patients with advanced NSCLC.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the predictive value of ProGRP,NSE and CYFRA21-1 levels for the therapeutic effect of EGFR-TKIs in patients with advanced NSCLC.Results:The proportion of patients with clinical stageⅣNSCLC in the disease control group was lower than that in the disease progression group(35.44%vs 70.37%)(χ^(2)=9.947,P<0.05).The proportion of patients with poorly differentiated tumors in the disease control group was also lower than that in the disease progression group(40.51%vs 62.96%)(χ^(2)=4.082,P<0.05).The levels of ProGRP,NSE and CYFRA21-1 in the disease control group were all lower than those in the disease progression group(P<0.05).Logistic regression analysis showed that the levels of ProGRP,NSE and CYFRA21-1,as well as clinical stage and tumor differentiation degree,were all factors influencing the therapeutic effect of EGFR-TKIs in patients with advanced NSCLC.ROC curve analysis revealed that the area under the curve(AUC)for predicting the therapeutic effect of EGFR-TKIs in patients with advanced NSCLC using ProGRP,NSE and CYFRA21-1 levels were 0.803,0.654 and 0.771,respectively.The AUC for combined diagnosis was 0.900,with a sensitivity and specificity of 81.50%and 93.65%,respectively.Conclusion:The levels of ProGRP,NSE and CYFRA21-1,as well as clinical stage and tumor differentiation degree,are all influencing factors of the therapeutic effect of EGFR-TKIs in patients with advanced NSCLC.ProGRP,NSE and CYFRA21-1 levels have certain predictive value for the therapeutic effect of EGFR-TKIs in patients with advanced NSCLC,and the combined predictive efficacy is higher.
作者
郭海军
杨保同
刘亚林
GUO Haijun;YANG Baotong;LIU Yalin(The First Affiliated Hospital,Clinical Medical College of Henan University of Science and Technology1.Department of Medical Laboratory;Central Laboratory,Luoyang 471000,China)
出处
《黑龙江医药科学》
2025年第9期5-9,共5页
Heilongjiang Medicine and Pharmacy
基金
2023年河南省医学科技攻关计划联合共建项目,编号:LHGJ20230444。
