Combined Detection CEA, CYFRA21-1 Of CA153 Positive Ⅲ ~ NSCLC Study The Efficacy And Prognosis Of Ⅳ

Objectives:To study the significance of combined testing of CEA (carcinoembryonic antigen) and CYFRA21-1(Cytokeratinfragmeantigen21-1) in determining the outcome and prognosis of CA153(Carbohydratantigen153) positive and CA153negative NSCLC (Non-small cell lung cancer) patients (Stage III to IV), and thus provide data for possible improvement of clinical diagnosis and treatment and mordification of chemo plan.Methods:We collected a series of60patients (n=60; male:29; female:31) with stage Ⅲ to Ⅳ NSCLC (based on initial tumor marker examination) in Tumor Hospital of Yunnan Province from2010October to2012October. All patients are diagnosed pathologically. Age ranges from74to32years (mean age:57.79year). We tested CEA, CA153and CYFRA21-1in all patients. Test group include30CA153positive (>30U/L) patients, while other30CA153negative (<30U/L) patients as control group. All patients were confirmed to be not suitable for any surgical interventions. Those without or unknown EGFR mutation and with ECOG score between0-2signed informed consent form for chemo therapy and agreed to preceed with chemo therapy. We used two-chemotherapeutics platinum-based chemotherapy (3rd generation of chemotherapeutics) recommended by internation protocol. Chemo period ranges from21days to28days.3ml of limosis vein blood were taken for Immune electrochemical luminescence checking of CEA (positive:>5ng/mL), CA153(positive:>30U/L) and CYFRA21-1(positive:>3.3ng/mL). We retrospectively analized CEA and CYFRA21-1change before chemo therapy, after2periods of chemo and after4periods of chemo, thus to determining the outcome and prognosis significance. We use Excel for initial data collection and SPSS17.0for data analysis. Chi-square test or Fisher’s actual probability comparison were used to perform random analysis of CA153positive and negative group, considering the impact of age, sex, clinical staging and pathological staging. Quantitative data of CEA and CYFRA21-1were tested for normality (all present skewness of the distribution, P<0.05). We use M±Q to describe the tendency of dispersion, and nonparametric rank sum test to study the difference between two groups of data:CEA and CYFRA21-1level before and after2periods of chemo; CEA and CYFRA21-1level before and after4periods of chemo; CEA and CYFRA21-1level after2and4periods of chemo; CEA and CYFRA21-1level before chemo between CA153positive and negative group; CEA and CYFRA21-1level after2periods of chemo between CA153positive and negative group; CEA and CYFRA21-1level after4periods of chemo between CA153positive and negative group. PFS (Progression-free survival, PFS) data presents normal distribution (P=0.05), and we use x±S to describe the central tendency of data:comparison of PFS between CA153positive group and negative group.(P≦0.05:statistically significant; P≦0.01:major statistical significance).Results:The variation of age P=0.938, sex P=0.438and tumor staging P=0.181in CA153positive group and CA153negative group were not statistically significant. Statistically significant is seen in the pathological staging between the two groups (P=0.013):CA153positive group has higher pathologicical staging than CA153negative group, while CA153positive group has more adenoma (P=0.013). CEA and CYFRA21-1levels before chemo administration and after2period of therapy:CEA and CYFRA21-1both drop significantly (P=0.008and0.000respectively). CEA and CYFRA21-1levels before chemo administration and after4period of therapy:CEA and CYFRA21-1both drop significantly (P=0.004and0.000respectively). CEA and CYFRA21-1levels after2period of therapy and4period of therapy:no significant change in CEA is observed (P=0.189), while CYFRA21-1drops significantly after additional2period of therapy (P=0.005). CEA and CYFRA21-1level in CA153positive group and negative group before or after chemo:for CEA, significant difference is observed between the two groupsbefore, after2periods of chemo therapy and after4periods (P=0.000,0.000, and0.000respectively); for CYFRA21-1, no significant difference is observed between the two groupsbefore therapy, while the differences are statistically significant between the two group after2periods and4periods of chemo (P=0.048and0.030respectively). For chemo therapy outcome and PFS, no significant difference is observed among the two groupsafter2periods and4periods of chemo therapy. Conclusion:1, Combined testing of CEA and CYFRA21-1is more valuable in post chemo evaluation comparing with testing each marker alone.2, Patinum-based chemotherapy (3rd generation of chemotherapeutics) can effectively reduce CEA and CYFRA21-1levels in stage Ⅲ to Ⅳ NSCLC patients, indicating its promising therapeutic effect.3, Combined testing of CEA and CYFRA21-1can be used to evaluate NSCLC patients’chemo outcome and prognosis.4, Differences in short-term chemo outcome is observed in NSCLC CA153positive group and negative group through combined testing of CEA and CYFRA21-1. Further observation and study on more samples are required to comfirm it.