中文摘要：

目的研究血清CYfra21-1在治疗Ⅲ、Ⅳ期肺鳞状细胞癌过程中的动态变化及与预后的关系.方法选择生存期均〈3年且治疗进程中均出现血清CYfra21-1的动态变化的肺鳞状细胞癌患者,其中ⅢA期组34例,ⅢB~Ⅳ期组32例.对ⅢA期及ⅢB~Ⅳ期患者的起始血清CYfra21-1水平、最低血清水平、开始增高时间、开始增高至死亡时间、倍增时间及年龄进行比较.对是否手术及上述指标进行单因素预后分析,对单因素预后分析有意义的指标纳入COX比例风险回归进行多因素预后分析.结果最低血清CYfra21-1在ⅢA期组（1.97±1.79ng/ml）中显著低于ⅢB~Ⅳ期组（4.78±2.88ng/ml）.ⅢB~Ⅳ期组开始增高的时间（6.59±5.24）月比ⅢA组（14.06±6.19）月更短,差异有统计学意义（P〈0.01）.血清CYfra21-1起始水平、最低水平、开始增高时间、倍增时间、是否手术与Ⅲ、Ⅳ期肺鳞状细胞癌患者的预后有关（P〈0.05）.多因素预后分析提示治疗后最低血清CYfra21-1水平、开始增高时间、倍增时间是独立的预后因素.结论Ⅲ、Ⅳ期肺鳞状细胞癌治疗过程中最低血清CYfra21-1水平、血清CYfra21-1开始升高时间、倍增时间是CYfra21-1动态变化中最重的预后因素.

英文摘要：

Objective To investigate the relationship between dynamic changes of serum CYfra21-1 levels and progno-sis of Ⅲ-Ⅳ stage lung squamous cell carcinoma. Methods Thirty four patients with stage ⅢA and 32 patients with ⅢB-Ⅳstage lung squamous cel carcinoma were enrol ed in the study. The serum CYfra21-1 levels were measured at different time points. Univariate analysis was performed to test the factors influencing the prognosis and significant factors from univariate anal-ysis entered into Cox proportion Hazards regression model for multivariate analysis. Results The valley levels of serum CYfra21-1 inⅢA stage group（1.97±1.79ng/ml） were significantly lower than those inⅢB-Ⅳgroup（4.78±2.88ng/ml）（P=0.000）. The rising of serum CYfra21-1 in ⅢB-Ⅳ stage （6.59±5.24months） was significantly earlier than that in ⅢA stage （14.06± 6.19months） （P=0.000）. Univariate analysis showed that the baseline level, val ey level, increasing time and doubling time of serum CYfra21-1, as wel as the receiving surgery were related to prognosis ofⅢ-Ⅳstage squamous cel carcinoma. Multivari-ate analysis revealed that the val ey value, increasing time, doubling time of serum CYfra21-1were independently prognostic fac-torss. Conclusion The dynamic changes of serum CYfra21-1may provide information for prognosis of patients withⅢ-Ⅳstage lung squamous cell carcinoma.