Clinical Significance Of Tumor Markers In Patients With Advanced Non-small Cell Lung Cancer

Objectives: To detect the serum levels of CEA, CYFRA21-1 and CA125 in patients with advanced non-small cell lung cancer before and after chemotherapy. To study the clinical significance and possible roles of CEA, CYFRA21-1, CA125 in the prognosis of advanced non-small cell lung cancer. Methods: A total of 45 patients diagnosed with stage IV non-small cell lung cancer were involved in this retrospectively study. All cases were treated in the second affiliated hospital, Zhejiang University college of medicine, during the period from January 2004 to July 2006. The ELISA assay was employed to detect the serum levels of CEA, CYFRA21-1 and CA125 in all patients before treatment and after two cycles of chemotherapy. The student-t test was used to evaluate the statistical significance of difference and P value less than 0.05 was considered to be significant. Results: (1)In patients with squamous cell carcinoma, the serum level of CYFRA21-1 after treatment was significantly lower than that before chemotherapy,(P=0.043). The serum levels of CEA and CA125 were also decreased after treatment, but the differences were not significant(P=0.385 and 0.488). In patients with adenocarcinoma, the serum levels of CEA and CA125 were significantly lower than those before chemotherapy (P=0.020 and 0.017). However, the CYFRA21-1 level did not changed obviously after treatment. (2)In patients with partial response (PR), the levels of CEA, CYFRA21-1 and CA125 were all significantly decreased after 2 cycles of chemotherapy. P values were 0.009, 0.002 and 0.015 respectively. In patients with stable disease (SD), the levels of CYFRA21-1 and CA125 were significantly lower after treatment (P=0.026 and 0.049), while there was no difference in CEA (P>0.05). In patients with disease progression (PD), the level of CEA after treatment was much increased than that before chemotherapy (P=0.016). But the differences of CYFRA21-1 and CA125 were no significant. Conclusions: The decrease of tumor marker levels in patients with advanced NSCLC after treatment may associate with the histological type of the tumor. Serum level of CYFRA21-1 in patients with squamous cell carcinoma may decrease obviously after treatment, while CEA and CA125 may decrease in patients with adenocarcinoma. CEA may be helpful for evaluating the short-period effect of chemotherapy. If CEA was decreased after chemotherapy, it may suggest a positive response to treatment. While in contrast, it may suggest a failure in treatment. CYFRA21-1 and CA125 may be good prognostic factors for patients with PR and SD, who benefit from the treatment. But for the PD patients, these two markers have little value.