Page 91 - 南京医科大学学报自然科学版

第42卷第6期 南京医科大学学报（自然科学版）
2022年6月 Journal of Nanjing Medical University（Natural Sciences） ·843 ·

·临床研究·

肺腺癌患者术前血清肿瘤标志物与微乳头、实体成分的关联研究

李志华，潘相龙，吴卫兵，陈 亮，何志成 *
南京医科大学第一附属医院胸外科，江苏 南京 210029

［摘 要］ 目的：本研究旨在分析肺腺癌患者术前血清肿瘤标志物与肺腺癌微乳头及实体成分的关联。方法：回顾性筛选
2018年1月—2020年12月于南京医科大学第一附属医院胸外科就诊的浸润性肺腺癌患者，采集患者术前血清肿瘤标志物［癌
胚抗原（carcinoembryonic antigen，CEA）、糖类抗原 199（carbohydrate antigen 199，CA19⁃9）、糖类抗原 724（carbohydrate antigen
724，CA724）、神经元特异性烯醇化酶（neuron specific enolase，NSE）、甲胎蛋白（alpha fetoprotein，AFP）及细胞角蛋白21片段抗
原（cytokeratin 21 fragment antigen，CYFRA21⁃1）］、病理亚型等信息。采用Student’s t⁃检验、卡方检验、Logistic回归等方法分析
血清肿瘤标志物与微乳头、实体成分等临床病理特征的关联。结果：共纳入2 159例肺腺癌患者，分别有291例及248例患者含
有微乳头、实体成分。6种肿瘤标志物中，CEA及CYFRA21⁃1与肿瘤大小、淋巴结转移显著相关（P < 0.001）。含实体成分的肺
腺癌患者，其CEA（2.92 ng/mL vs. 1.88 ng/mL，P < 0.001）及CYFRA21⁃1（2.20 ng/mL vs. 2.02 ng/mL，P < 0.001）表达显著高于不含
实体成分的患者。同样，CEA（2.59 ng/mL vs. 1.92 ng/mL，P < 0.001）及CYFRA21⁃1（2.15 ng/mL vs. 2.03 ng/mL，P=0.009）在含微
乳头成分肺腺癌中的表达显著高于不含微乳头成分者。单因素回归分析显示，性别、肿瘤大小、CEA及CYFRA21⁃1与微乳头
及实体成分有关。多因素回归分析表明，CEA 与实体（OR = 2.87，95%CI：2.03～4.06，P < 0.001）、微乳头（OR = 2.36，95%CI：
1.68～3.32，P < 0.001）成分的关联仍然显著，而 CYFRA21⁃1 与微乳头、实体成分的关联不再具有统计学意义（P > 0.05）。结
论：肺腺癌患者术前血清CEA及CYFRA21⁃1表达与微乳头、实体成分有关，可能作为肺腺癌微乳头、实体成分的预测因子。
［关键词］ 肺腺癌；血清肿瘤标志物；微乳头成分；实体成分；CEA；CYFRA21⁃1
［中图分类号］ R734.2 ［文献标志码］ A ［文章编号］ 1007⁃4368（2022）06⁃843⁃07
doi：10.7655/NYDXBNS20220612

Study of the associations between preoperative serum tumor markers and the
micropapillary and solid components in patients with lung adenocarcinoma
*
LI Zhihua，PAN Xianglong，WU Weibing，CHEN Liang，HE Zhicheng
Department of Thoracic Surgery，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，China

［Abstract］ Objective：This study aims to analyze the associations between preoperative serum tumor markers and the micropapillary
and solid components in patients with lung adenocarcinoma. Methods：Patients with invasive lung adenocarcinoma who underwent
treatment in our department from January 2018 to December 2020 were retrospectively screened. Preoperative serum tumor markers
［carcinoembryonic antigen（CEA），carbohydrate antigen 199（CA19⁃9），carbohydrate antigen 724（CA724），neuron specific enolase
（NSE），alpha fetoprotein（AFP）and cytokeratin 21 fragment antigen（CYFRA21 ⁃ 1）］，histopathological subtypes and other
2
characteristics were collected. Student’s t⁃test，χ test，logistic regression analyses were used to evaluate the relations between serum
tumor markers and the micropapillary and solid components，as well as other clinicopathological characteristics. Results：A total of
2 159 lung adenocarcinoma patients were enrolled in the current study. There were 291 and 248 patients harboring micropapillary and
solid components，respectively. Among these six tumor markers，CEA and CYFRA21⁃1 levels were significantly associated with tumor
size and lymph node metastasis（P < 0.001）. Patients with solid components had a higher CEA（2.92 ng/mL vs. 1.88 ng/mL，P < 0.001）
and CYFRA21⁃1（2.20 ng/mL vs. 2.02 ng/mL，P < 0.001）level than those absence of solid components. Similarly，the expression levels
of CEA（2.59 ng/mL vs. 1.92 ng/mL，P < 0.001）and CYFRA21⁃1（2.15 ng/mL vs. 2.03 ng/mL，P=0.009）in patients with micropapillary
components were significantly higher than that in patients without micropapillary components. The univariate regression analysis

［基金项目］ 国家自然科学基金（81972175）；白求思·爱惜康卓越外科基金（HZB⁃20190528⁃16）
∗
通信作者（Corresponding author），E⁃mail：zhicheng.he@njmu.edu.cn