Résumé
Aims: The aim of this study is to investigate patients with unresectable Stage III non-small-cell lung cancer (NSCLC) receiving radiotherapy with induction and concurrent pemetrexed or docetaxel plus cisplatin (PP/DP) chemotherapy and to identify the subgroup most likely to benefit from induction chemotherapy (IC). Subjects and Methods: Patients with unresectable measurable Stage III NSCLC received two cycles of PP/DP IC followed by concurrent chemoradiotherapy at a dose of 60–66 Gy. Statistical Analysis Used: Cox regression analysis was performed to evaluate the prognostic factors for survival; logistic regression analysis was used to evaluate the predictors for response to IC, and the receiver operating characteristic curves were used to evaluate the independent factors predicting response. Results: Eighty patients were included; the median survival time (MST) was 22.1 months. Partial response (PR) to IC was an independent prognostic factor for overall survival. For patients in the PR and stable disease groups, the MST was 36.7 and 19.5 months, respectively. The independent predictors of PR to IC included classification as stage N3 cancer, baseline carcinoembryonic antigen (CEA) levels >10 ng/ml, and cytokeratin fragment 19 (CYFRA21-1) levels >6 ng/ml. With each additional independent predictor, the likelihood of having have PR to IC increased. Conclusions: Radiotherapy with induction and concurrent PP/DP chemotherapy is feasible for patients with unresectable Stage III NSCLC. IC may improve the survival of IC responders, as predicted by elevated CEA and CYFRA21-1 levels and classification as stage N3 cancer. Additional randomized trials on IC may consider these predictors to tailor individualized treatments
Résumé
Objective To investigate the value of combined detection by using tumor markers cytokeratin‐19 fragment antigen (CYFRA21‐l) ,neuron‐specific enolase (NSE) ,carcinoembryonic antigen (CEA) and carbohydrate cancer antigen 125(CA125) in lung cancer diagnosis .Methods 200 people who treated in the hospital in related departments from January 2012 to January 2014 were enrolled in the study .100 of them suffered from lung cancer ,53 suffered from benign lung disease ,the rest 47 were healthy people .Electrochemiluminescence method or enzyme‐linked immunosorbent assay(ELISA) were used to detect serum tumor mark‐ers CYFRA21‐1 ,NSE ,CEA ,CA125 and the sensitivity ,specificity and accuracy of different combinations of test items were evalua‐ted .Results In the single detection of those tumor markers for the diagnosis of lung cancer ,CYFRA21‐1 detection got the highest sensitivity and accuracy ,while CA125 got the highest specificity(95 .0% ) .The sensitivity and specificity of combined detection were both significantly higher than single detections .The sensitivity ,pecificity and accuracy of the combined detection of the 4 tumor markers were 92 .0% ,72 .0% ,and 87 .0% respectively .Conclusion In the clinical diagnosis of lung cancer ,the combined detection of several serum tumor markers get higher sensitivity and accuracy than single detection ,which is worthy of clinical promotion .
Résumé
Objective To explore the clinical value of tumor marker squamous cell carcinoma antigen(SCCA) ,tissue polypeptide specific antigen(TPS) ,neuron‐specific enolase(NSE) ,cytokeratin fragment 19(CYFRA21‐1) detections in the patient with lung cancer .Methods 70 patient with newly diagnosed lung cancer(including 26 cases of squamous cell carcinoma ,23 cases of adenocar‐cinoma and 21 cases of small cell carcinoma) ,40 cases of lung benign diseases and contemporaneous 30 individuals undergoing the physical examination were randomly selected as the lung cancer group ,lung benign disease group and healthy control group respec‐tively .Serum tumor markers of SCCA ,TPS ,NSE and CYFERA21‐1 were detected in all cases .Then the detection results were per‐formed the statistical analysis .Results The levels of SCCA ,TPS ,NSE and CYFERA21‐1 in the lung cancer group were significant‐ly higher than those in the lung benign diseases group and healthy control group ,the differences were statistically significant (P0 .05) .The combination detection of SCCA , TPS ,NSE and CYFERA21‐1 greatly increased the sensitivity and accuracy for diagnosing lung cancer .Conclusion The combina‐tion detection of SCCA ,TPS ,NSE and CYFERA21‐1 has very high clinical value for the diagnosis ,pathological typing and assisted clinical therapy of lung cancer .