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目的评价血清糖类抗原(CA125)水平与非小细胞肺癌(NSCLC)预后的关系。方法对56例NSCLC病人(TNM分期Ⅰ、Ⅱ、ⅢA期)于术前及术后随访时检测血清CA125水平。结果术前CA125水平高于正常值的23例患者中术后14例(60.9%)复发,术前CA125水平正常的33例中术后9例(27.3%)复发,前者较后者更易复发(P<0.01),3年后无病生存率前者(39.1%)低于后者(69.7%)(P<0.01)。术前血清CA125增高是术后复发危险的独立指标(风险率:3.08;95%CI:0.89～10.63),且提示肿瘤扩散的风险增加(风险率:7.00%,95%CI:2.39～20.51)。23例术后肿瘤复发及扩散者中13例(56.5%)CA125增高。术后血清CA125对肿瘤扩散者敏感性较高(66.7%),对局部复发者敏感性低(37.5%),对肿瘤复发及扩散预测的特异性为43.5%。结论CA125是NSCLC有效的预后指标,对术前评估肿瘤复发及扩散的风险尤有价值;术后随访监测CA125对诊断肿瘤复发尚无足够的特异性和敏感性。
Objective To evaluate the relationship between the level of serum carbohydrate antigen (CA125) and the prognosis of non-small cell lung cancer (NSCLC). Methods 56 cases of NSCLC patients (TNM staging Ⅰ, Ⅱ, Ⅲ A) at preoperative and postoperative follow-up test serum CA125 levels. Results Of the 23 patients (60.9%) who had preoperative CA125 levels higher than normal, 14 (27.3%) patients relapsed after operation, of whom 33 (27.3%) had normal recurrence of CA125 before operation. P <0.01). The former had a lower disease-free survival rate after 3 years (39.1%) than the latter (69.7%) (P <0.01). Preoperative serum CA125 elevation was an independent marker of postoperative recurrence risk (hazard ratio: 3.08; 95% CI: 0.89 to 10.63) and suggested an increased risk of tumor spread (hazard ratio: 7.00%, 95% CI: 2.39-20.51) . Thirteen (56.5%) CA125 increased in 23 patients with tumor recurrence and proliferation. Postoperative serum CA125 was more sensitive to tumor proliferation (66.7%), less sensitive to local recurrence (37.5%), and to tumor recurrence and spread prediction (43.5%). Conclusions CA125 is an effective prognostic indicator of NSCLC. It is particularly valuable for the preoperative evaluation of the risk of tumor recurrence and spread. The follow-up monitoring of CA125 is not yet specific and sensitive for the diagnosis of tumor recurrence.