Prediction Of Serum Levels Of HIF-1α、VEGF、CYFRA21-1、 And CEA From Advanced Non-small-cell Lung Cancer Patients In Chemotherapeutic Efficacy And Survival Time

Objective: To investigate the correlations of the expression level of serum hypoxia-inducible factor(HIF-1α), vascular endothelial growth factor(VEGF), cytokeratin 19 fragment(CYFRA21-1) and carcinoembryonic antigen(CEA), chemotherapy effect in advanced non-small-cell lung cancer(NSCLC) patients,and survival time. Methods: A total of 169 cases of advanced NSCLC in oncology department,respiratory department and thoracic surgery department from Jun. 2013 to Jun. 2015 were enrolled in this study. The levels of serum HIF-1α, VEGF, CYFRA21-1 and CEA were detected by the method of enzyme-linked immunosorbent(ELISA) before and after two cycles of chemotherapy. The relationships between tumor markers and histological type,clinical stage with NSCLC patients were analyzed. The relationship between tumor markers changes and chemotherapy effect was researched,and survival analysis was conducted using Kaplain-Meier method. Results:1.The positive rate of CYFRA21-1 in squamous carcinoma and CEA in adenocarcinoma had significant difference(P<0.01). The positive rate of HIF-1αand VEGF had no significant difference(P>0.05) in different pathological typ es.The positive rate of CYFRA21-1 in squamous carcinoma and CEA in adeno ca--rcinoma could be significantly improved by combining with HIF-1α(P<0.05).2.The surum HIF-1α,VEGF,CYFRA21-1 and CEA levels in stage III and IV had significantly difference.Single detection and 4 kinds of TM joint detecti--on in positive rate difference between the phase III and IV had no statistical significance.The positive rate of TM joint detection was higher than the single detection.3.The levels of serum HIF-1α, CYFRA21-1 and CEA decreased significan--tly compared with prior chemotherapy in patients with(CR+PR) and SD(P<0.01).HIF-1α,CYFRA21-1,CEA increased significantly in the(PD) patients(P<0.05).4.The total accordance rate between clinical effect evaluation(CR+PR+SD+PD) and every TM effect evaluation(HIF-1α,VEGF,CYFRA21-1,CEA) had no significantly difference(P>0.05). The accordance rate between TM effect evalua--tion and clinical effect evaluation of(CR+PR+PD) had significant difference(P<0.05).The accordance rate of HIF-1α in effect evaluation were relatively hi--gher, but VEGF lower.5.In the clinical effect evaluation, the accordance rate between HIF-1α+ CYFRA21-1+CEA and CYFRA21-1+CEA had significant difference(P<0.05).6.In patients of squamous cell carcinomas with effect evaluation CR+PR and SD,the accordance rate of HIF-1α+CYFRA21-1 was improved significantly compared with CYFRA21-1(P<0.05); In patients of adenocarcinoma with effectevaluation CR+PR and SD,the accordance of HIF-1α+CEA was improved sig--nificantly compared with CEA(P<0.05).7.No matter the every kind of TM increasing, decreasing or stable after chemotherapy,PFS had no significant difference(P>0.05). Conclusion:1.The serun HIF-1α,CYFRA21-1 and CEA could contribute to the diagnosis of pathological types and stages in NSCLC.2.The joint detection of HIF-1α,CYFRA21-1 and CEA could reflect the chemotherapeutic effect better.3.The expression levels of serum HIF-1α,CYFRA21-1,NSE,CEA before and after chemotherapy have no prognostic value to PFS in NSCLC.