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目的探讨晚期非小细胞肺癌(NSCLC)患者2周期化疗前后CEA水平变化评价影像学肿瘤疾病控制的效能和预后的价值,为2周期后是否调整治疗方案提供依据。方法回顾性分析53例NSCLC患者化疗前、2周期化疗后血液中CEA水平变化;应用ROC曲线评价CEA水平变化对于化疗后影像学疗效达疾病控制(DC)的评价效能;探讨CEA水平变化与预后的关系。结果CEA水平变化率评价DC的ROC曲线下面积为0.794,CEA水平变化率阈值为-34.0%,此时敏感度和特异度分别为80.0%和87.5%。CEA水平变化与DC呈明显正相关(r=0.526,P<0.01)。CEA变化阳性的患者肿瘤无疾病进展时间(PFS)明显长于阴性患者(中位值分别为6.87和2.77个月,P<0.05)。CEA水平变化及化疗周期数、体重变化均是预测PFS的独立预后因子(均P<0.05)。结论在CEA水平升高的晚期NSCLC患者中,2周期化疗前后CEA水平变化可以有效评价影像学DC和预测PFS,CEA水平变化可作为影像学评价的重要辅助工具,有利于全面评估疗效。
Objective To investigate the changes of CEA levels in patients with advanced non-small cell lung cancer (NSCLC) before and after 2 cycles of chemotherapy to evaluate the efficacy and prognosis of the imaging tumor control and to provide evidence for whether to adjust the treatment plan after 2 cycles. Methods The CEA levels in blood of 53 patients with NSCLC before and after 2 cycles of chemotherapy were retrospectively analyzed. The ROC curve was used to evaluate the efficacy of CEA in evaluating the efficacy of imaging for disease control (DC) after chemotherapy. The changes of CEA level and prognosis Relationship. Results The area under the ROC curve of CEA was 0.794, and the threshold of CEA level change was -34.0%. The sensitivity and specificity were 80.0% and 87.5% respectively. The level of CEA was positively correlated with DC (r = 0.526, P <0.01). Patients with positive CEA changes had significantly longer progression-free tumor progression time (PFS) than negative patients (median, 6.87 and 2.77, respectively, P <0.05). The change of CEA level, the number of cycles of chemotherapy and body weight were independent predictors of PFS (all P <0.05). CONCLUSION: CEA levels in patients with advanced NSCLC with elevated CEA levels before and after 2 cycles of chemotherapy can effectively evaluate imaging DC and predict PFS. The changes of CEA levels can be used as an important imaging aid in assisting in the comprehensive evaluation of the therapeutic effect.