非小细胞肺癌远处转移相关血清指标及临床 特征研究

Study on Serum Indicators and Clinical Characteristics Related to Distant Metastasis of Non-Small Cell Lung Cancer

摘要: 目的：探讨纤维蛋白原(FIB)、血清肿瘤标志物及肿瘤大小等指标与非小细胞肺癌(NSCLC)远处转移的相关性，为临床诊断及预后评估提供参考。方法：回顾性分析2019~2024年在重庆大学附属肿瘤医院确诊的NSCLC患者临床资料，根据是否发生远处器官转移分为转移组(366例)和非转移组(328例)。对比两组患者FIB、血清肿瘤标志物【神经元特异性烯醇化酶(NSE)、癌胚抗原(CEA)、糖类抗原125 (CA125)、细胞角蛋白19片段(CYFRA21-1)等】、肿瘤大小及临床特征等指标与远处转移的关联；同时从病理类型、肿瘤大小、肿瘤位置三个维度进行亚组分析，进一步探讨上述指标与NSCLC远处转移的相关性。结果：肿瘤远处转移组FIB、NSE、CEA、CA125、CYFRA211血清阳性率均显著高于非转移组(all P < 0.05)，上述指标与NSCLC远处转移呈密切相关；年龄、血小板(PLT)、胃泌素释放肽前体(ProGRP)两组间分布差异无统计学意义(all P > 0.05)，与远处转移无明显关联。亚组分析中，不同肿瘤大小、肿瘤位置亚组内FIB、CEA、NSE、CA125、CYFRA21-1仍与转移状态显著相关(all P < 0.05)，可作为鉴别NSCLC是否发生远处转移的稳定预测指标。结论：FIB、CEA、NSE、CA125、CYFRA21-1与NSCLC患者远处转移存在相关性，可为NSCLC远处转移的临床诊断及预后评估提供一定的参考价值。

Abstract: Objective: To investigate the correlation between fibrinogen (FIB), serum tumor markers, tumor size and other indicators with distant metastasis in non-small cell lung cancer (NSCLC), so as to provide a reference for clinical diagnosis and prognosis evaluation of NSCLC patients. Methods: A retrospective analysis was conducted on the clinical data of patients diagnosed with NSCLC at Chongqing University Cancer Hospital from 2019 to 2024. The patients were divided into distant metastasis group (366 cases) and non-distant metastasis group (328 cases) according to the presence or absence of distant organ metastasis. The two groups were compared in terms of fibrinogen (FIB), serum tumor markers including neuron-specific enolase (NSE), carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125) and cytokeratin 19 fragment (CYFRA21-1), as well as tumor size and clinicopathological characteristics, to analyze their association with distant metastasis. Meanwhile, subgroup analysis was conducted according to pathological type, tumor size and tumor location, so as to further explore the correlation between the above indicators and distant metastasis of non-small cell lung cancer (NSCLC). Results: The serum positive rates of FIB, NSE, CEA, CA125 and CYFRA21-1 in the metastatic group were significantly higher than those in the non-metastatic group (all P < 0.05), and the above indicators were closely correlated with distant metastasis of NSCLC. There were no statistically significant differences in age, platelet (PLT) and progastrin-releasing peptide (ProGRP) between the two groups (all P > 0.05), which showed no obvious association with distant metastasis. In subgroup analysis, FIB, CEA, NSE, CA125 and CYFRA21-1 were still significantly correlated with metastatic status in subgroups stratified by tumor size and tumor location (all P < 0.05), which could serve as stable predictive indicators for identifying the presence or absence of distant metastasis in NSCLC patients. Conclusions: FIB, CEA, NSE, CA125 and CYFRA21-1 are correlated with distant metastasis in NSCLC patients, and they have certain clinical significance for the diagnosis and prognosis evaluation of NSCLC patients with distant metastasis.