Clinical Significance Of Combined Determination Of Serum CEA, CYFRA21-1 And NSE In Patients With Non-small Cell Lung Cancer

ObjectiveTo investigate the Clinical significance of serum CEA, CYFRA21-1 and NSE in patients with non-small cell lung cancer on Diagnosis, Staging, monitoring effect and judging prognosis.MethodsThe serum levels of CEA, CYFRA21-1 and NSE were measured with an electrochemiluminescense immunoassay in 133 patients with NSCLC at baseline and after 2 cycles of first-line chemotherapy. The data were correlated with radiologic objective response (OR) and survival results. To evaluate the role of CEA, CYFRA21-1 and NSE response in predicting response to therapy, receiver operating characteristic curves (ROC) were constructed.ResultsPositive rate of CEA was highest in patients with adenocarcinoma(88.7%), while postive rate of CYFRA21-1 was highest in patientswith with squamous cell carcinoma(59.8%).Combined determination of serum CEA, CYFRA21-1 and NSE can raise the postive rate obviously(91.7%).The radiologic OR rate was 40.6%(54/133) after 2 cycles of the chemotherapy. The best cut of point of CEA CYFRA21-1 and NSE for predicting efficient were 17.6%,40.3%and 27.1%, respectively. The predictive efficient rate of CEA, CYFRA21-1 and NSE responses were 46.6%(62/133), 30.8%(41/133) and 36.1%(48/133), respectively. The median survival was 11 months. Statistically significant correlations were observed between CEA and CYFRA21-1 responses and OR (P<0.05), but serum NSE responses was not related with OR (P=0.112). In a univariate analysis, the pathalogical Staging,performance status, pathalogical type, pretreatment serum CEA level, radiologic objective response, CEA, CYFRA21-1 and NSEresponses were correlated significantly with the survival (P<0.05). In a multivariate analysis, pathalogical type, pretreatment serum CEA level, radiologic objective response, CEA and CYFRA21-1 responses were confirmded as independent prognostic factors for the survival (P<0.05).ConclusionCombined determination of serum CEA, CYFRA21-1 and NSE in patients with non-small cell lung cancer can raise the diagnosis rate and judge the pathology type further more. Serum CEA and CYFRA21-1 responses appear to be reliable surrogate markers of chemotherapy efficacy in patients with advanced NSCLC. A significant decline in serum CEA, CYFRA21-1 and NSE during the chemotherapy indicates a good prognosis.