| Background and purposeIn nowdays, lung cancer has become one of the highest incidence of malignanttumor in the current, and its mortality is also ranked first.5-year survival rate ofpatients with early stage in lung cancer is more than90%, but the most lung cancerpatients has been to the advanced when they are diagnosed. Therefore, chemotherapyis the primary means of comprehensive treatment of advanced lung cancertreatment.Promptly and effectively assessment of the efficacy of chemotherapy isparticularly important. Currently, both at home and abroad we all use the ResponseEvaluation Criteria in Solid Tumors Europe and the National Cancer Institute’s(NCI-RECIST) version1.0for efficacy evaluation, As the main evaluation tools,imaging examinations has certain limitations, they can not reflect the true efficacy ofchemotherapy fully.Compared with imaging examinations, tumor markers (Tumorrmarker, TM) testing has variety of advantages,such as simple, accurate, relativelylow cost,and no radiation hazards. And a number of domestic and internationalstudies have shown that tumor markers can predict the therapeutic effect beforetreatment and early treatment of tumors, Evaluation of changes the biological behavior of the tumor in the course of treatment, monitoring tumor response, hopes tobecome one of the primary means of evaluation of the efficacy of lung cancer.This study retospectively analyzed serum tumor markers of advanced non-smallcell lung cancer patients.before and after treated with chemotherapy for statisticalanalysis, We Analysis quantitative the relationships between the change of serumCEA levels and the survival of disease detection, trying to predict quantitativeindicators up to further explore the role of tumor markers in the advanced non-smallcell lung cancer patients with chemotherapy, and provide evidence and guidance forthe clinical application of the CEA.Materials and methodsWe analysed87cases patients with III~IV non-small cell lung cancer who areenrooled in the First Affiliated Hospital of Zhengzhou University and Henan TumorHospital from July2011to July2013,all patients are untreated previously. Wecollected data of patients through follow-up mersures and the access to of medicalrecords.The data include smoking status, gender, age, TNM staging, pathological type,treatment, efficacy evaluation, progression-free survival, etc.We Enrolled87patientswho were the first to receive platinum-based chemotherapy or TKI therapy. andwhose baseline level of CEA or CEA for the first time after chemotherapy wereelevated (>10ng/ml). Serum CEA are Detected using electrochemiluminescenceimmunoassay (full kit and E170analyzer is provided by the Swiss company RocheDiagnostics). In strict accordance with the operating manual instruments and reagents,quality control conducted by Roche control solution. Data are analyzed using SPSS17.0software. After calculating the two treatment cycles of chemotherapy beforeCEA CEA relative decline in the percentage established by the establishment of theROC curve optimal cut-off point, Kaplan Meier method (log rank test) analyze theimpact on the optimal cut-off point decline in the rate of CEA efficacy againstNSCLC. With P <0.05was considered statistically significant. Results1Generally this group of patientsNa ve patients were87cases, including70cases of adenocarcinoma, non-adenocarcinoma in17cases.45cases of them are male patients,42cases femalepatients.Median age of diagnosis was58years (25to77years);48patients werenon-smokers,39patients were smokers.According to the International Union AgainstCancer (the Intcmational Union Against Cancer, UICC)7th edition TNM staging oflung cancer staging principles:there is40cases in phase of III,and IV of47cases;Allpatients were receiving anti-cancer therapy for the first time, with platinum-basedchemotherapy in76cases,11cases of single-agent TKI therapy. All patientscompleted2cycles of chemotherapy, there is a complete test results beforechemotherapy and after two cycles of chemotherapy。2CEA level and rate of change in the relationship between chemotherapyafter two cycles of chemotherapyROC curve area of the CEA rate of change with chemotherapy is0.898(95%CI0.831-0.964), while the best cut-off point of CEA is decreased to17.0%, thensensitivity were86.9%and specificity were84.6%.3Relationship of serum CEA after2cycles of chemotherapy, the rate ofchange and disease-free survival in patientsReduce the magnitude of the ROC curve based on the best cutoff pointcorresponding to the CEA,87patients were divided into CEA reduced>17%of thegroup and the CEA group≤17%drop.comparing two groups of disease-freesurvival (PFS), CEA reduced>17%group median PFS was9.0months (95%CI of7.76~10.23), CEA reduced≤17%median PFS was5.2months (95%CI of3.88~6.52)(λ2=24.596, P <0.001) ConclusionIf patients’ CEA levels drop to a certain extent after chemotherapy.it Means thatchemotherapy is effective. And they would had longer PFS... |
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