| During the origin and development of the tumor,tumor markers can reflect the existence and growth of the tumor, which are produced and secreted by the tumor and are released into the blood,body fluids and tissues. The examination of the serum tumor markers can help the diagnosis judgment of the pathological types and therapeutic effects and provide clues for progress and prediction of outcome in lung cancer patients. The rise of tumor makers often are discovered in patients with advanced disease, but according to clinical observation, tumor makers of some patients is always normal in the progressions of the diseases,whether there are differences of clinical character and prognosis between them or not is lack of the results of systematic analysis by literature retrieval. The paper tend to explore the clinical character and prognosis of non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC)which their serum tumor makers are normal by comparing the similarities and differences of clinical character and prognosis between lung cancer patients with normal tumor makers and lung cancer patients with high tumor makers to deepen the understanding of lung cancer patients with normal serum tumor makers.Method:We collecte the clinical data (age, gender, smoking history, family history, pathological type, the clinical stage, tumor location transfer parts and chemotherapy curative effect.etc) of NSCLC、SCLC patients, which are confirmed by pathology in our hospital from January2006to Dec2012;and we visit the lifetime of patients by telephone or query case until Dec2013NSCLC patients are divided to tumor marker-negative group and tumor marker-positive group,according to the levels of the carcinoembryonic antigen (CEA), sugar chain antigen CA125, CA199, CA153, and cytokeratin19fragment (CYFRA21-1) antigen and squamous cell carcinoma antigen (SCC);and SCLC patients are divided to tumor marker-negative and tumor marker-positive,according to neuron specific enolization gastrin-releasing peptide precursor (ProGRP) and neuron specificity enolization enzyme (NSE). To understand the differences between patients with tumor marker-negative and tumor marker-positive we compare to the general data, the pathological type, the clinical stage, tumor location,transfer parts.ect and analyze the prognosis of the two group patients by SPSS17.0.Results:1. There are343patients of NSCLC including65patients of tumor marker-negative and278patients of tumor marker-positive. There is no significant difference between the two groups of NSCLC patients in the general epidemiological data (age, gender, family history, smoking history), tumor location, pathological classification, the effect of first-line chemotherapy (P>0.05);2.The NSCLC patients of tumor marker-negative with pathological stage Ⅰ+Ⅱ is19patients (19/65,29.23%),31patients with Ⅲ stage (31/65,47.69%),15patients with Ⅳ stage (15/65,23.05%).The tumor marker-positive NSCLC patients is37patients with Ⅰ+Ⅱ stage(37/278,19.31%),90patients with III stage (90/278,32.37%),151patients with IV stage (151/278,54.32%).The difference is statistically significant (P<0.01).3.The rate of bone metastases in NSCLC patients of tumor marker-negative is lower than tumor marker-positive patients (14.29%vs31.96%, P<0.05). The rate of brain metastases in NSCLC patients of tumor marker-negative is lower than tumor marker-positive patients (7.69%vs18.34%, P<0.05). There is no significant difference between the two groups in the rate of liver metastasis and drenal metastasis.4.The survival of tumor marker-negative NSCLC patients is longer than patients of tumor marker-positive.The median survival time is47±5.056month of tumor marker-negative NSCLC patients,while it is17±1.087month in patients of tumor marker-positive (P＜0.001).5.There are112patients of SCLC including15patients of tumor marker-negative and97patients of tumor marker-positive. There were no significant difference between the two groups of SCLC patients in the general epidemiological data (age, gender, family history, smoking history), primary location of tumor, the clinical stage.etc (P>0.05); Meanwhile the incidence of bone metastases, brain metastasis, liver metastasis, adrenal metastasis, pericardial transfer and the effect of first-line chemotherapy and the median survival time also have no significant difference (P>0.05).Conclusion:1. There is no statistical difference in age, gender, family history, smoking history, primary location of tumor, pathological types, the effect of first-line chemotherapy.etc between NSCLC patients of tumor marker-negativel and patients NSCLC of tumor marker-positive.2. The rate of early stage NSCLC patients in tumor marker-negative group is higher than patients in tumor marker-positive group.3. The incidence rate of brain metastases is lower in patients of tumor marker-negative than patients of tumor marker-positive.4. The median survival time of tumor marker-negative NSCLC patients is longer than that of tumor marker-positive patients.5. There is no statistical difference in age, gender, family history, smoking history primary location of tumor, metastasi positions, original clinical stage, the effect of first-line chemotherapy and survival analysis between SCLC patients of tumor marker-negativel and patients of tumor marker-positive.During the origin and development of the tumor,tumor markers which is always normal may be associated with the biological characteristics of tumor cells,which have lower invasiveness. mobility and irritating to normal cells. Tumor marker-negative can help prompt earlier clinical stage,lower metastasis and longer survival time.Beacase the sample size of tumor marker-negative patients is too small,the results may be deviation in SCLC patient. We need expanding the sample size in prospective study to get reliable conclusion,. |
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