The Change And Clinical Significance Of Serum CYFRA21-1Level Before And After The Surgery, Chemotherapy In Patients With Squamous Cell Carcinomas

Background：Lung cancer is the malignant epithelial tumors which derived frombronchial epithelial, Lung Squamous Cell Carcinoma (SCC) is the most common typeof lung cancer, accounting for about40%per cent of primary lung cancer. Due to thelung Squamous Cell Carcinoma, transfer later, prognosis is better after resection, forall and selected stageⅠ、Ⅱand Ⅲa, surgery is the preferred treatment method,because surgery effect and postoperative survival time, postoperative recurrence andmetastasis are closely related, so the operation effect of judgment is especiallyimportant; while stage Ⅲb、Ⅳ， chemotherapy, radiation therapy, as its maintreatment, The Present evidence indicated that platinum-based drugs combinedchemotherapy scheme is the standard of care in advanced lung squamous cellcarcinomas， monitored during chemotherapy chemotherapy on the treatmentprogramme is also very important for the future.Currently, clinical judgment of surgery effect、the decision whether to continuechemotherapy in patients is on the basis of imaging is reached more imaging of ease(objective response, OR). However, when surgical treatment of squamous cellcarcinoma of the lung, due to the tumor’s size, location, lymph node metastases andoccult metastasis, completeness of the operation and its rate of recurrence and metastasis cannot be properly assessed; While chemotherapy for squamous cellcarcinoma of the lung, accompanied by Pleural effusions, atelectasis, diffuse lesion ofpatients, evaluation based on Imaging OR is difficult. Therefore, testing tumor marker(TM) has come under attention, serum Cytokeratin19fragments (CYFRA21-1) is oneof the specific tumor markers in lung Squamous Cell Carcinoma,which has beenwidely used for the effect of early diagnosis, monitoring and prognosis of lungsquamous cell carcinoma.Objective: Imaging information cannot find the potential for distant metastases,measurement focus cannot be accurately evaluated, nor on survival of tumor tissue fortesting,the use of tumor markers can be effective to fill the shortage of the imaging.This study by detecting lung squamous cell carcinoma patients，serum levels ofCYFRA21-1expression before and after operation and chemotherapy in order toobserve its clinical value in evaluating the effect of lung squamous carcinoma surgeryand chemotherapy response.Methods：1. The surgery group: Select Continuous50cases who accept surgeryand the postoperative pathology diagnosed Ⅰa period-Ⅲa period in lung squamouscarcinoma,35cases of which accept complete resection of lung cancer (radicaloperation for lung cancer group),15cases of acceptance of incomplete resection oflung cancer (palliative surgery for lung cancer group).2set of objects, respectively,determination of peripheral blood concentration CYFRA21-1at different times,3times of sampling time, respectively is1d before surgery,7d and30d after surgery.Bycomparing various groups within and between preoperative and postoperative changesof serum CYFRA21-1levels in different periods, to gauge their significance in effectevaluation of surgical treatment of squamous cell carcinoma of the lung.2.The chemotherapy group: Select130cases of consecutive stageⅢb-Ⅳ lungsquamous carcinoma confirmed by pathology, were accepted2cycle GP package(cisplatin plus gemcitabine) combined chemotherapy. Respectively detecting the expression level of fasting serum CYFRA21-1before the first cycle of chemotherapyin patients and after the second cycle of chemotherapy,and at the same time imagingexamination to evaluate objectively curative effect, Image according to RECISTcriteria (RECIST) assessment of efficacy is divided into different clinical groups，respectively are: set of complete remission (CR), partially offset Group (PR), diseasegroups (SD), disease progression Group (PD). By analyzing the changes of serumCYFRA21-1level in different therapeutic group, to determine its clinical significancein evaluating the effect of chemotherapy in lung squamous carcinoma,along withROC curves, In order to evaluate effectiveness of serum CYFRA21-1reaction in thediagnosis of OR.Results：1. The surgery group: the radical operation for lung cancer group,serum CYFRA21-1levels of7days,30days postoperativeis significantly lowerbefore1day preoperation, and showed a trend of progressive decrease,(P<0.01); theradical operation for lung cancer group, serum CYFRA21-1levels of7days,30dayspostoperative is reduced before1day preoperation,(P<0.05), But the differencebetewn serum CYFRA21-1level in7days postoperative and30days postoperativehas no statistically significant (P>0.05). The serum CYFRA21-1of7dayspostoperative is lower more apparent in completely cure group than that in palliativeoperation group,(P>0.05); the serum CYFRA21-1level of30days postoperative incompletely radical and palliative group is significantly reduced when compared withthe same period in palliative operation group (P <0.05).2.The chemotherapy group:There are112cases in group after2cycles ofchemotherapy, including CR group of10cases (8.9%), PR group of25cases (22.3%),the SD group of47cases (42.0%), PD group of30patients (26.8%), imaging effectivegroup a total of35cases (31.2%), invalid group with77cases (68.8%)；The serumCYFRA21-1levels in CR group patients is significantly decreased (P<0.01), Theserum CYFRA21-1levels in PR group patients is decreased (P<0.05), The serum CYFRA21-1levels in SD group patients is decreased (P>0.05), The serumCYFRA21-1levels in PD group patients is significantly increased (P<0.01), theimaging ease (OR) and the change of serum CYFRA21-1has significant statisticalcorrelation (P<0.05); According to the ROC curve analysis, serum CYFRA21-1levelsdecreased after treatment are greater than27.0%are defined as serum CYFRA21-1reaction, because at this level have the best sensitivity and specificity of the diagnosticimaging OR.Conclusion：Changes of serum CYFRA21-1levels can be sensitive to thesurvival of tumor tissue, i.e., the change of tumor load, has the potential to beauxiliary curative effect assessment of effect of surgery and chemotherapy in patientswith lung squamous carcinoma.