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Value of Circulating Tumor Cells and Tumor Markers in Peripheral Blood for Evaluating the Curative Effect on Elderly Patients with Non-Small Cell Lung Cancer After Chemotherapy |
LI Xiaohua, LI Jie, TANG Junwei |
Nanchong Central Hospital, North Sichuan Medical College, Sichuan Nanchong 637000, China |
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Abstract Objective: To explore the value of circulating tumor cells (CTCs) and tumor markers in peripheral blood for evaluating the curative effect on elderly patients with non-small cell lung cancer (NSCLC) after chemotherapy. Methods: A total of 86 elderly NSCLC patients admitted to the hospital from September 2017 to February 2019 and confirmed by pathological examination were enrolled as the research subjects. All underwent chemotherapy with docetaxel and cisplatin. The levels of CTCs in peripheral blood, serum neuron specific enolase (NSE), cytoplasmic thymidine kinase-1 (TK-1) and midkine (MK) were detected before chemotherapy. The clinical curative effect after 6 months of treatment was evaluated. The evaluation value of peripheral blood CTCs, serum NSE, TK-1 and MK for curative effect on elderly NSCLC patients after chemotherapy was analyzed by univariate analysis, multivariate Logistic regression analysis and ROC curve analysis. Results: After chemotherapy, there were 49 cases (56.98%) effective, who were included into effective group, and there were 37 cases (43.02%) ineffective, who were included into ineffective group. After test, levels of serum NSE, TK-1 and MK, and positive rate of CTCs in ineffective group were significantly higher than those in effective group (P<0.05). The positive rate of CTCs was significantly positively correlated with the expression of serum NSE, TK-1 and MK (P<0.05). The results of univariate analysis showed that there were significant differences in TNM staging of tumors, peripheral blood CTCs, serum NSE, TK-1 and MK between the two groups (P<0.05). The results of multivariate regression analysis showed that positive peripheral blood CTCs, serum NSE not lower than 40.0 ng/ml, TK-1 not lower than 4.5 ng/ml and MK not lower than 0.8 ng/ml were independent predictors of ineffective curative effect on elderly NSCLC patients after chemotherapy. The results of ROC curve analysis showed that area under the ROC curve (AUC) of serum NSE, TK-1 and MK alone for predicting ineffective curative effect on elderly NSCLC patients after chemotherapy was lower than that of their combination (P<0.05). Conclusion: The high positive expression rate of peripheral blood CTCs, and high expression of serum NSE, TK-1 and MK are important influencing factors of ineffective curative effect on elderly NSCLC patients after chemotherapy. The combined detection of the three is of good application value in evaluating the curative effect on elderly NSCLC patients after chemotherapy.
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[1] Ronny B A,Ronit F,Alon B N,et al.Establishment of adoptive cell therapy with tumor infiltrating lymphocytes for non-small cell lung cancer patients[J].Cancer Immunology Immunotherapy,2018,67(8):1221~1230. [2] 刘东,王保庆.外周血循环肿瘤细胞检测在非小细胞肺癌治疗的疗效判断及预后预测中的作用[J].临床医学研究与实践,2020,5(5):110~112. [3] 姜祥宁,武红莉,邓小梅,等.血清NSE与Cyfra21-1水平在小细胞肺癌与非小细胞肺癌辅助诊断中的价值[J].实用癌症杂志,2018,33(6):55~57,74. [4] 石远凯,孙燕,于金明,等.中国晚期原发性肺癌诊治专家共识(2016年版)[J].中国肺癌杂志,2016,9(1):1~15. [5] 杨学宁,吴一龙.实体瘤治疗疗效评价标准-RECIST[J].循证医学,2004,4(2):25~30. [6] 葛含天,朱万森,黄建中.循环肿瘤细胞定量检测在非小细胞肺癌患者中的应用价值研究[J].中国全科医学,2017,20(S3):144~146. [7] 卢央芳,仇建波,张占春,等.培美曲塞联合顺铂对晚期非小细胞肺癌的化疗效果和血清肿瘤标志物的影响[J].中国卫生检验杂志,2019,29(9):1080~1082. [8] 隋东江,刘小静,李海燕,等.血清CEA、CYFRA21-1表达与晚期NSCLC患者化疗效果的关系及疗效影响因素分析[J].癌症进展,2019,17(2):187~189. [9] 朱园园,张兰胜.非小细胞肺癌循环肿瘤细胞检测在化疗中的应用[J].临床肺科杂志,2019,24(5):164~166. [10] 苟小丽,苑成,柏玉举,等.外周血循环肿瘤细胞数目与老年晚期非小细胞肺癌患者疗效及预后的相关性[J].中国老年学杂志,2020,40(2):281~284. [11] 张颖,董秀鹏,杜静,等.肿瘤标志物CYFRA21-1、SCC、CEA、NSE、CA125检验在肺癌诊断中的价值[J].现代肿瘤医学,2018,26(11):1701~1703. [12] 刘昱,武彩虹,田雪梅,等.血清TK-1、SE-CAD表达及联合HE4、CEA、CYFRA21-1检测在非小细胞肺癌诊断中的意义[J].标记免疫分析与临床,2019,26(6):960~962. |
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